ArticleBJOG : an international journal of obstetrics and gynaecology2025
Measures of Structural Racism and Black-White Disparity in Stillbirth Rates in New York City, 2009-2018: A Population-Based Cross-Sectional Study.
Article in BJOG : an international journal of obstetrics and gynaecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Economic connectedness and fetal and infant death: a population-based cross-sectional study of California.Journal of epidemiology and community health · 2026Article
- Sequential Safety Surveillance of RSVpreF Vaccination During Pregnancy Early in the Postapproval Period.JAMA network open · 2026Article
- Association of Prepregnancy Cardiovascular Risk Factors Clusters With Stillbirth Risk Across Racial and Ethnic Groups: A Nationwide Population-Based Study of 31.4 Million Singleton Births and 131 047 Stillbirths.Journal of the American Heart Association · 2025Article
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7 authors.
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Abstract
objectiveTo explore associations between measures of structural racism and stillbirth.
designPopulation-based cross-sectional.
settingNew York City (NYC), USA. POPULATION: All non-Hispanic Black and White singleton births 2009-2018.
methodsWe modelled associations between measures of structural racism (Indices of Dissimilarity, Isolation and Concentration at the Extremes [ICE] and an Educational Inequity Ratio) and stillbirth. For indicators with evidence of interaction with race, we estimated odds ratios for stillbirth separately in 221 925 Black and 325 058 White births. OUTCOME MEASURE: Stillbirth (fetal death at 20+ completed gestational weeks).
resultsThe stillbirth rate (per 1000 total births) was 13.8 in Black and 4.7 in White births. For Black mothers, residence in privileged versus disadvantaged PUMAs (Public Use Microdata Areas) (ICE Quintile 5 vs. 1) was associated with 54% greater odds of stillbirth (95% confidence interval, CI, 1.11, 2.14), and residence in more versus less isolated PUMAs (Isolation Tertile 3 vs. 1) was associated with 36% lower odds of stillbirth (95% CI 0.51, 0.82). There were no associations between measures of structural racism and stillbirth in White births.
conclusionsICE and Isolation were associated with stillbirth in Black but not White births, but associations were not in the expected direction, raising questions about whether and how these measures represent structural racism. NYC stillbirths comprise about 4% of the USA's stillbirths but 15% of all Black stillbirths. Hence, reductions in racial disparities in stillbirth rates in NYC will also contribute to national public health.
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