Higher rates of necrotizing enterocolitis (NEC) in black preterm infants have been attributed to the higher rates of preterm delivery in this population. The focus however has been on preterm infant risk factors with minimal investigation into the contribution of antepartum differences among black women and how they may contribute to poorer outcomes in the black preterm infant. Retrospective cohort controlled study design examined the relationship between maternal infection, preterm infant infection, race and NEC. Black women were found to experience an increased number of maternal infections when compared to white and Hispanic women. Of the black mothers who experienced infection during pregnancy their preterm infants had a more cycles of antibiotic administration than white and Hispanic infants. Preterm infants who experienced increased exposure to antibiotics had higher risk for necrotizing enterocolitis. © 2013 Elsevier Inc.