Costs per infant hospitalization were highest for extremely preterm infants, although the larger number of moderately preterm/low birth weight infants contributed more to the overall costs. Preterm/low birth weight infants in the United States account for half of infant hospitalization costs and one quarter of pediatric costs, suggesting that major infant and pediatric cost savings could be realized by preventing preterm birth.

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Objective Term pregnancy (37–41 weeks of gestation) is generally regarded as a uniform period for pregnancy outcome. The purpose of this study was to estimate the trend of maternal racial/ethnic differences in mortality for early term (37 0/7 – 38 6/7 weeks of gestation) compared to full term births (39 0/7 – 41 6/7 weeks of gestation). Methods We analyzed 46,329,018 singleton live births using the National Center for Health Statistics (NCHS) U.S. period-linked birth/infant death data from 1995 to 2006. Infant mortality rates (IMR), neonatal mortality rates (NMR), and postneonatal mortality rates (PNMR) were calculated according to gestational age, race/ethnicity, and cause of death. Results Overall, IMR has decreased for early term and full term births between 1995 and 2006. At 37 weeks of gestation, Hispanics had the greatest decline in IMR, 35.4% (4.8/1000 to 3.1/1000), followed by 22.4% for whites (4.9/1000 to 3.8/1000),whereas blacks had the smallest decline, 6.8% (5.9/1000 to 5.5/1000), due to a stagnant NMR. When 37 weeks is compared to 40 weeks of gestation, NMR is increased : Hispanics: RR= 2.6 (95% CI 2.0–3.3); whites: RR= 2.6 (95% CI 2.2–3.1); and blacks: RR= 2.9 (2.2–3.8). There is still excess NMR at 38 weeks of gestation. At both early and full term gestations, NMR is 40% higher and PNMR is 80% higher for blacks whereas Hispanics have a reduced PNMR when compared to whites. Conclusion Early term births are associated with higher NMR, PNMR, and IMR compared to full term births, with concerning racial/ethnic disparity in rates and trends.