Previous studies have shown that babies born to Black mothers are twice as likely to die within the first month compared with babies born to white women.

However, a study published in the journal Pediatrics found that this racial disparity is heightened for Black women who use in vitro fertilization (IVF), fertility drugs or other fertility treatments.

Of the more than 7.5 million births from 2016 to 2017, 93,000 children were conceived through fertility treatments, such as IVF. Researchers found that death rates were more than four times higher for newborns up to 28 days old born to Black mothers who utilized fertility technologies.

Specifically, Babies born to Black mothers had a 1.6% death rate compared with 0.3% for babies born to white women.

The study’s lead author, Sarka Lisonkova, MD, PhD, an associate professor of obstetrics and gynecology at the University of British Columbia, said these results were unexpected because her team believed women who could afford IVF, regardless of race, would receive high-quality care.

But Black women who use reproductive technologies are, like Black women who conceive spontaneously, often refused additional tests and treatments and are referred to specialists less frequently, according to Madeline Sutton, MD, an Atlanta-based ob-gyn who was not involved in this study.

“Once that pregnancy happens, the women are in the same system that has all those things that we haven’t yet fully accounted for—the systemic biases, the racism, the differences in treatments based on what type of insurance someone might have,” Sutton said in an NBC news article.

Lisonkova noted that the overall risk of negative IVF outcomes is relatively low and “that shouldn’t preclude women from seeking fertility care.”