Odds of infant mortality higher among US-born than non-US-born individuals

U.S.-born individuals have higher odds of infant mortality than non-U.S.-born individuals, according to a study published online Jan. 6 in JAMA Network Open.

Nicolette Christodoulakis and Giulia M. Muraca, M.P.H., Ph.D., from McMaster University in Hamilton, Ontario, Canada, examined the associations between maternal nativity status and infant mortality by maternal race and ethnicity in the United States in a retrospective, population-based cohort study using linked birth and infant death records. Of the 25,981,364 births, 20,141,084 and 5,840,280 (77.5% and 22.5%) were to U.S.-born and non-U.S.-born individuals, respectively.

The researchers found that U.S.-born individuals had a higher infant mortality rate than non-U.S.-born individuals (5.4 versus 4.0 deaths per 1,000 births; adjusted odds ratio [aOR], 1.34). This disparity was seen mainly for full-term births (aOR, 1.58) and was less clear among preterm births.

Among full-term births in U.S.-born individuals, those identifying as Black, Hispanic, White, or more than one race had higher rates of infant mortality (aORs, 1.55, 1.39, 1.45, and 1.33, respectively). There were differences in leading causes of death by nativity, race, and ethnicity; among full-term births, higher odds of sudden unexpected infant death were seen among U.S.-born individuals versus their non-U.S.-born counterparts (aOR, 2.90).

“These results highlight the impact of nativity, race, and ethnicity on infant mortality, emphasizing the need for investigation into the underlying factors contributing to these disparities among full-term births,” the authors write.

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