Continuing Challenges in Reduction of Neonatal Mortality

The higher proportion of preterm births among persons of lower socioeconomic groups is well documented worldwide. In the United States, the continuing excess mortality among nonwhite compared with white infants has as a major component the associated differences in socioeconomic status.

A perplexing problem has been how to peer into the black box called socioeconomic status. Most of us trained in medicine have few ideas or resources with which to make fundamental changes in socioeconomic status beyond advocacy as a citizen. Indeed, even the economists seem to find that a tough assignment. On the other hand, as physicians, we have an obligation to understand what factors predispose a given pregnancy to risk of bad outcome. Thus, it is time to try to ascertain those components associated with lower socioeconomic status that can be identified and studied with the goal of prevention of preterm labor.

In this issue of the Journal