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Preterm Delivery: Can We Lower the Black Infant's First Hurdle?

Carol J. R. Hogue, MPH, PhD; Ray Yip, MD, MPH
JAMA. 1989;262(4):548-550. doi:10.1001/jama.1989.03430040120039.
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The article by Klebanoff et al1 in this issue of The Journal disputes previously published work by Lieberman et al2 that suggests anemia may explain a major proportion of the difference in preterm delivery rates between blacks and whites. This controversy highlights the importance of closing the enormous black-white gap in infant mortality in the United States. Over the last two decades, our infant mortality rate has fallen from 7th to 19th among developed countries. This deterioration in a prominent indicator of our nation's health has led to substantial federal, state, and local concern to accelerate improvements in infant health. The problem of infant mortality is particularly apparent among black infants who continue to experience twice the risk of death and low birth weight as white infants—ratios that have remained unchanged over two decades. In fact, a black infant born in 1985 had less chance of living


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