Early mortality among triplets in the United States: Black-white disparity

Objective: In this study, we sought to estimate the black-white gap in early mortality among trip lets. Study design: This was a retrospective cohort study on triplets delivered in the United States from 1995 to 1997. We computed relative risks for early mortality among triplets born to black mothers using the generalized estimating equation framework. Results: There were 1317 black and 14,364 white triplets analyzed. Black triplets were twice as likely to have neonatal and infant mortality compared with whites (Odds ratio [OR], 2.00, 95% CI, 1.38-2.77; and OR, 2.20, 95% CI, 1.59-3.00, respectively). The widest disparity was observed postneonatally, with black triplets sustaining a level of risk almost 4-fold that of whites (OR, 3.60, 95% CI, 2.10-6.10). Stillbirth and perinatal mortality were comparable for both races. Conclusion: Black-white disparity for early mortality among triplets was widest postneonatally. This finding bears important clinical and public health implications. (C) 2004 Elsevier Inc. All rights reserved.