TY - JOUR
T1 - Experiences of Racism and Preterm Birth
T2 - Findings from a Pregnancy Risk Assessment Monitoring System, 2004 through 2012
AU - Bower, Kelly M.
AU - Geller, Ruth J.
AU - Perrin, Nancy A.
AU - Alhusen, Jeanne
N1 - Funding Information:
This publication was made possible by the Johns Hopkins Institute for Clinical and Translational Research (ICTR), which is funded in part by Grant Number KL2TR001077 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Johns Hopkins ICTR, NCATS, or NIH. This publication was also supported by a career development award from the National Institute of Nursing Research (NINRK23NR015810; PI: J. Alhusen) and grant R40MC28309, MCH Research Program, from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services. The authors thank the Pregnancy Risk Assessment Monitoring System Working Group of the Centers for Disease Control and Prevention for their guidance and provision of the 2004–2012 Pregnancy Risk Assessment Monitoring System data.
Publisher Copyright:
© 2018 Jacobs Institute of Women's Health
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Background: Racial disparities in birth outcomes represent a significant public health concern in the United States. Factors associated with racism have been posited as a mechanism underlying these disparities. Yet, findings from previous studies are mixed and based on small, geographically limited samples. This study aims to examine the relationship between experiences of racism and preterm birth in a population-based sample and to explore the role of adequacy of prenatal care within that relationship. Methods: Data from the 2004 through 2012 Pregnancy Risk Assessment Monitoring System were analyzed. The sample included non-Hispanic Black mothers from 11 states and New York City who delivered neonates from 2004 to 2012 (n = 11,582). Survey-weighted regression analyses were used to examine the association between women feeling upset by experiences of racism in the 12 months before delivery and subsequent preterm birth. Adequacy of prenatal care was tested as an effect modifier. Results: Feeling upset by experiences of racism was significantly associated with greater odds of preterm birth (adjusted odds ratio, 1.29; 95% CI, 1.04–1.59). Results from interaction models revealed that the associations of experiences of racism with preterm birth differed by level of prenatal care, although the interaction term was not significant. Conclusions: Findings suggest that, for non-Hispanic Black women, the emotional effect of experiences of racism may contribute to the risk of preterm birth. Future studies should consider the role of adequate prenatal care in this relationship. Racism is an important public health problem with a measurable impact on preterm birth and should be addressed to eliminate racial inequities in birth outcomes.
AB - Background: Racial disparities in birth outcomes represent a significant public health concern in the United States. Factors associated with racism have been posited as a mechanism underlying these disparities. Yet, findings from previous studies are mixed and based on small, geographically limited samples. This study aims to examine the relationship between experiences of racism and preterm birth in a population-based sample and to explore the role of adequacy of prenatal care within that relationship. Methods: Data from the 2004 through 2012 Pregnancy Risk Assessment Monitoring System were analyzed. The sample included non-Hispanic Black mothers from 11 states and New York City who delivered neonates from 2004 to 2012 (n = 11,582). Survey-weighted regression analyses were used to examine the association between women feeling upset by experiences of racism in the 12 months before delivery and subsequent preterm birth. Adequacy of prenatal care was tested as an effect modifier. Results: Feeling upset by experiences of racism was significantly associated with greater odds of preterm birth (adjusted odds ratio, 1.29; 95% CI, 1.04–1.59). Results from interaction models revealed that the associations of experiences of racism with preterm birth differed by level of prenatal care, although the interaction term was not significant. Conclusions: Findings suggest that, for non-Hispanic Black women, the emotional effect of experiences of racism may contribute to the risk of preterm birth. Future studies should consider the role of adequate prenatal care in this relationship. Racism is an important public health problem with a measurable impact on preterm birth and should be addressed to eliminate racial inequities in birth outcomes.
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U2 - 10.1016/j.whi.2018.06.002
DO - 10.1016/j.whi.2018.06.002
M3 - Article
C2 - 30049447
AN - SCOPUS:85050179546
VL - 28
SP - 495
EP - 501
JO - Women's Health Issues
JF - Women's Health Issues
SN - 1049-3867
IS - 6
ER -