Relation of Poverty and Race to Antenatal Infection

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Abstract
Perinatal infant mortality rates in poor families in the United States are far higher than rates in the non-poor. Analysis of 1044 consecutive autopsies on stillborn and newborn infants in New York City demonstrated congenital pneumonia or sepsis (or both), primarily related to the aspiration of infected amniotic fluid, in 27 per cent. The poorest families had about twice the rate of infections as the most prosperous, and blacks about double the rate of whites and Puerto Ricans. Adrenal glands were 19 per cent heavier in infected than in noninfected infants, owing to increased cytoplasmic mass of individual cells in the permanent zone of the gland. Hyperfunction of these adrenal cells offers a possible mechanism by which infection may initiate labor.