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DOI: 10.1055/s-0032-1326988
Ethnic and Racial Disparities in the Risk of Preterm Birth: A Systematic Review and Meta-Analysis
Publication History
06 February 2012
24 May 2012
Publication Date:
11 October 2012 (online)
Abstract
Objectives The aim of this study is to present a systematic review of available literature on the effect of maternal ethnicity (Africans/blacks, Asians, Hispanics, others) on the risk of preterm birth (PTB).
Study Design Studies investigating ethnicity (or race) as a risk factor for PTB were included if performing adjustments for confounders. A meta-analysis was performed, and data were synthesized using a random effects model.
Results Forty-five studies met the inclusion criteria. Black ethnicity was associated with an increased risk of PTB when compared with whites (range of adjusted odds ratios [ORs] 0.6 to 2.8, pooled OR 2.0; 95% confidence interval [CI] 1.8 to 2.2). For Asian ethnicity, there was no significant association (range of adjusted ORs 0.6 to 2.3). For Hispanic ethnicity, there also was no significant association (range of adjusted ORs 0.7 to 1.5).
Conclusions Ethnic disparities in the risk of PTB were clearly pronounced among black women. Future research should focus on preventative strategies for ethnic groups at high risk for PTB. Information on ethnic disparities in risk of PTB-related neonatal morbidity and mortality is lacking and is also a topic of interest for future research.
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References
- 1 Slattery MM, Morrison JJ. Preterm delivery. Lancet 2002; 360: 1489-1497
- 2 Wen SW, Smith G, Yang Q, Walker M. Epidemiology of preterm birth and neonatal outcome. Semin Fetal Neonatal Med 2004; 9: 429-435
- 3 Demissie K, Rhoads GG, Ananth CV , et al. Trends in preterm birth and neonatal mortality among blacks and whites in the United States from 1989 to 1997. Am J Epidemiol 2001; 154: 307-315
- 4 Joseph KS, Kramer MS, Marcoux S , et al. Determinants of preterm birth rates in Canada from 1981 through 1983 and from 1992 through 1994. N Engl J Med 1998; 339: 1434-1439
- 5 Joseph KS, Kramer MS. Recent versus historical trends in preterm birth in Canada. CMAJ 1999; 161: 1409
- 6 Norman JE, Morris C, Chalmers J. The effect of changing patterns of obstetric care in Scotland (1980–2004) on rates of preterm birth and its neonatal consequences: perinatal database study. PLoS Med 2009; 6: e1000153
- 7 Tracy SK, Tracy MB, Dean J, Laws P, Sullivan E. Spontaneous preterm birth of liveborn infants in women at low risk in Australia over 10 years: a population-based study. BJOG 2007; 114: 731-735
- 8 Burke C, Morrison JJ. Perinatal factors and preterm delivery in an Irish obstetric population. J Perinat Med 2000; 28: 49-53
- 9 Iannucci TA, Tomich PG, Gianopoulos JG. Etiology and outcome of extremely low-birth-weight infants. Am J Obstet Gynecol 1996; 174: 1896-1900 ; discussion 1900–1902
- 10 Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008; 371: 75-84
- 11 Steer P. The epidemiology of preterm labour. BJOG 2005; 112 (Suppl. 01) 1-3
- 12 Bryant AS, Worjoloh A, Caughey AB, Washington AE. Racial/ethnic disparities in obstetric outcomes and care: prevalence and determinants. Am J Obstet Gynecol 2010; 202: 335-343
- 13 USDHHS. Healthy people 2010: Midcourse review. Available at: http://www.healthypeople.gov/ . Accessed 1 Feb 2012
- 14 Goldenberg RL, Cliver SP, Mulvihill FX , et al. Medical, psychosocial, and behavioral risk factors do not explain the increased risk for low birth weight among black women. Am J Obstet Gynecol 1996; 175: 1317-1324
- 15 Jackson N. Systematic reviews of health promotion and public health interventions handbook. Cochrane Collaboration Health Promotion and Public Health Field. Australia, Carlton South; 2006
- 16 Senior PA, Bhopal R. Ethnicity as a variable in epidemiological research. BMJ 1994; 309: 327-330
- 17 Effective Public Health Practice Project. Quality assessment tool for quantitative studies. 2002. Hamilton, Ontario, Canada: McMaster University. , 2002. Available at: www.ephpp.ca/PDF/QATool.pdf . Accessed 1 Feb 2012
- 18 Blumenshine P, Egerter S, Barclay CJ, Cubbin C, Braveman PA. Socioeconomic disparities in adverse birth outcomes: a systematic review. Am J Prev Med 2010; 39: 263-272
- 19 de Costa C, Child A. Pregnancy outcomes in urban aboriginal women. Med J Aust 1996; 164: 523-526
- 20 Luo Z-C, Wilkins R, Platt RW, Kramer MS. Fetal and Infant Health Study Group of the Canadian Perinatal Surveillance System. Risks of adverse pregnancy outcomes among Inuit and North American Indian women in Quebec, 1985–97. Paediatr Perinat Epidemiol 2004; 18: 40-50
- 21 Schieve LA, Handler A. Preterm delivery and perinatal death among black and white infants in a Chicago-area perinatal registry. Obstet Gynecol 1996; 88: 356-363
- 22 Cervantes A, Keith L, Wyshak G. Adverse birth outcomes among native-born and immigrant women: replicating national evidence regarding Mexicans at the local level. Matern Child Health J 1999; 3: 99-109
- 23 Patel RR, Steer P, Doyle P, Little MP, Elliott P. Does gestation vary by ethnic group? A London-based study of over 122,000 pregnancies with spontaneous onset of labour. Int J Epidemiol 2004; 33: 107-113
- 24 Zhang J, Savitz DA. Preterm birth subtypes among blacks and whites. Epidemiology 1992; 3: 428-433
- 25 Getahun D, Ananth CV, Selvam N, Demissie K. Adverse perinatal outcomes among interracial couples in the United States. Obstet Gynecol 2005; 106 (1) 81-88
- 26 Alexander GR, Wingate MS, Mor J, Boulet S. Birth outcomes of Asian-Indian-Americans. Int J Gynaecol Obstet 2007; 97 (3) 215-220
- 27 Singh GK, Yu SM. Adverse pregnancy outcomes: differences between US- and foreign-born women in major US racial and ethnic groups. Am J Public Health 1996; 86: 837-843
- 28 Gold KJ, Demonner SM, Lantz PM, Hayward RA. Prematurity and low birth weight as potential mediators of higher stillbirth risk in mixed black/white race couples. J Womens Health 2010; 19 (4) 767-773
- 29 Cox RG, Zhang L, Zotti ME, Graham J. Prenatal care utilization in Mississippi: racial disparities and implications for unfavorable birth outcomes. Matern Child Health J 2011; 15: 931-942 [epub ahead of print 2009 Nov 27]
- 30 Howard DL, Marshall SS, Kaufman JS, Savitz DA. Variations in low birth weight and preterm delivery among blacks in relation to ancestry and nativity: New York City, 1998–2002. Pediatrics 2006; 118 (5) e1399-e1405
- 31 Collins J, Hammond NA. Relation of maternal race to the risk of preterm, non-low birth weight infants: a population study. Am J Epidemiol 1996; 143 (4) 333-337
- 32 Zeitlin J, Bucourt M, Rivera L, Topuz B, Papiernik E. Preterm birth and maternal country of birth in a French district with a multiethnic population. BJOG: An International Journal of Obstetrics and Gynaecology 2004; 111 (8) 849-855
- 33 Lu MC, Chen B. Racial and ethnic disparities in preterm birth: the role of stressful life events. Am J Obstet Gynecol 2004; 191 (3) 691-699
- 34 Shiono PH, Klebanoff MA. Ethnic differences in preterm and very preterm delivery. Am J Public Health 1986; 76 (11) 1317-1321
- 35 Brown HL, Chireau MV, Jallah Y, Howard D. The “Hispanic paradox”: an investigation of racial disparity in pregnancy outcomes at a tertiary care medical center. Am J Obstet Gynecol 2007; 197 (2) 197.e1-197.e7
- 36 Frisbie WP, Biegler M, de Turk P, Forbes D, Pullum SG. Racial and ethnic differences in determinants of intrauterine growth retardation and other compromised birth outcomes. Am J Public Health 1997; 87 (12) 1977-1983
- 37 Goedhart G, Van EM, van der Wal MF, Bonsel GJ. Ethnic differences in preterm birth and its subtypes: the effect of a cumulative risk profile. BJOG: An International Journal of Obstetrics and Gynaecology 2008; 115 (6) 710-719
- 38 Shen JJ, Tymkow C, MacMullen N. Disparities in maternal outcomes among four ethnic populations. Ethn Dis 2005; 15: 492-497
- 39 Leland NL, Petersen DJ, Braddock M, Alexander GR. Variations in pregnancy outcomes by race among 10–14-year-old mothers in the United States. Public Health Rep 1995; 110: 53-58
- 40 Zanconato G, Iacovella C, Parazzini F, Bergamini V, Franchi M. Pregnancy outcome of migrant women delivering in a public institution in northern Italy. Gynecol Obstet Invest 2011; 72: 157-162
- 41 Blackmore-Prince C, Kieke Jr. B, Kugaraj KA, Ferre C, Elam-Evans LD, Krulewitch CJ , et al. Racial differences in the patterns of singleton preterm delivery in the 1988 National Maternal and Infant Health Survey. Matern Child Health J 1999; 3 (4) 189-197
- 42 Barros FC, Victora CG, Horta BL. Ethnicity and infant health in Southern Brazil. A birth cohort study. Int J Epidemiol 2001; 30 (5) 1001-1008
- 43 Collins J, David RJ, Simon DM, Prachand NG. Preterm birth among African American and white women with a lifelong residence in high-income Chicago neighborhoods: an exploratory study. Ethn Dis 2007; 17 (1) 113-117
- 44 Verkerk PH, Zaadstra BM, Reerink JD, Herngreen WP, Verloove-Vanhorick SP. Social class, ethnicity and other risk factors for small for gestational age and preterm delivery in The Netherlands. Eur J Obstet Gynecol Reprod Biol 1994; 53 (2) 129-134
- 45 Silva LM, Silva RA, Silva AA, Bettiol H, Barbieri MA. Racial inequalities and perinatal health in the southeast region of Brazil. Braz J Med Biol Res 2007; 40: 1187-1194
- 46 Adams MM, Read JA, Rawlings JS, Harlass FB, Sarno AP, Rhodes PH. Preterm delivery among black and white enlisted women in the United States Army. Obstet Gynecol 1993; 81: 65-71
- 47 Simhan HN, Krohn MA. Paternal race and preterm birth. Am J Obstet Gynecol 2008; 198 (6) 644.e1-644.e6
- 48 Stein CR, Savitz DA, Janevic T, Ananth CV, Kaufman JS, Herring AH , et al. Maternal ethnic ancestry and adverse perinatal outcomes in New York City. Am J Obstet Gynecol 2009; 201 (6) 584.e1-584.e9
- 49 Kistka ZAF, Palomar L, Lee KA, Boslaugh SE, Wangler MF, Cole FS , et al. Racial disparity in the frequency of recurrence of preterm birth. Am J Obstet Gynecol 2007; 196 (2) 131.e1-131.e6
- 50 Blackmore CA, Savitz DA, Edwards LJ, Harlow SD, Bowes J. Racial differences in the patterns of preterm delivery in central North Carolina, USA. Paediatr Perinat Epidemiol 1995; 9 (3) 281-295
- 51 Shen TT, DeFranco EA, Stamilio DM, Chang JJ, Muglia LJ. A population-based study of race-specific risk for preterm premature rupture of membranes. Am J Obstet Gynecol 2008; 199 (4) 373.e1-373.e7
- 52 Schempf AH, Mendola P, Hamilton BE, Hayes DK, Makuc DM. Perinatal outcomes for Asian, Native Hawaiian, and other Pacific Islander mothers of single and multiple race/ethnicity: California and Hawaii, 2003–2005. Am J Public Health 2010; 100: 877-887
- 53 Li Q, Keith LG, Kirby RS. Perinatal outcomes among foreign-born and US-born Chinese Americans, 1995–2000. J Immigr Minor Health 2010; 12: 282-289
- 54 Yi JD, Schiff MA, Boutain D. Adverse birth outcomes among Korean women compared to white women in the United States. Matern Child Health J 2012; 16: 760-766
- 55 Wong LF, Caughey AB, Nakagawa S, Kaimal AJ, Tran SH, Cheng YW. Perinatal outcomes among different Asian-American subgroups. Am J Obstet Gynecol 2008; 199 (4) 382.e1-382.e6
- 56 Liu C-Y, Chang N-T, Chou P. Testing the “epidemiologic paradox” of birth outcomes among Asian immigrant women in Hsin-Chu County, Taiwan. Taiwan Yi Xue Hui Za Zhi 2008; 107 (10) 782-790
- 57 Rao AK, Cheng YW, Caughey AB. Perinatal complications among different Asian-American subgroups. Am J Obstet Gynecol 2006; 194 (5) e39-e41
- 58 Rao AK, Daniels K, El-Sayed YY, Moshesh MK, Caughey AB. Perinatal outcomes among Asian American and Pacific Islander women. Am J Obstet Gynecol 2006; 195 (3) 834-838
- 59 Aveyard P, Cheng KK, Manaseki S, Gardosi J. The risk of preterm delivery in women from different ethnic groups. BJOG: An International Journal of Obstetrics and Gynaecology 2002; 109 (8) 894-899
- 60 Nystrom MJ, Caughey AB, Lyell DJ, Druzin ML, El-Sayed YY. Perinatal outcomes among Asian-white interracial couples. Am J Obstet Gynecol 2008; 199 (4) 385.e1-385.e5
- 61 Taipale P, Hiilesmaa V. Predicting delivery date by ultrasound and last menstrual period in early gestation. Obstet Gynecol 2001; 97: 189-194
- 62 Bergsjø P, Denman III DW, Hoffman HJ, Meirik O. Duration of human singleton pregnancy. A population-based study. Acta Obstet Gynecol Scand 1990; 69: 197-207
- 63 Tunón K, Eik-Nes SH, Grøttum P. A comparison between ultrasound and a reliable last menstrual period as predictors of the day of delivery in 15,000 examinations. Ultrasound Obstet Gynecol 1996; 8: 178-185
- 64 Alexander GR, Wingate MS, Boulet S. Pregnancy outcomes of American Indians: contrasts among regions and with other ethnic groups. Matern Child Health J 2008; 12 (Suppl. 01) S5-S11
- 65 Auger N, Chery M, Daniel M. Rising disparities in severe adverse birth outcomes among Haitians in Quebec, Canada, 1981–2006. J Immigr Minor Health 2012; 14 (2) 198-208 [epub ahead of print 2011 March 20]
- 66 Jolly MC, Sebire N, Harris J, Robinson S, Regan L. Obstetric risks of pregnancy in women less than 18 years old. Obstet Gynecol 2000; 96: 962-966
- 67 Donders AR, van der Heijden GJ, Stijnen T, Moons KG. Review: a gentle introduction to imputation of missing values. J Clin Epidemiol 2006; 59: 1087-1091
- 68 Shah PS, Zao J, Al-Wassia H, Shah V. Knowledge Synthesis Group on Determinants of Preterm/LBW Births. Pregnancy and neonatal outcomes of aboriginal women: a systematic review and meta-analysis. Womens Health Issues 2011; 21: 28-39
- 69 Dominguez TP. Race, racism, and racial disparities in adverse birth outcomes. Clin Obstet Gynecol 2008; 51: 360-370
- 70 Langridge AT, Nassar N, Li J, Stanley FJ. Social and racial inequalities in preterm births in Western Australia, 1984 to 2006. Paediatr Perinat Epidemiol 2010; 24 (4) 352-362
- 71 Melamed Y, Bashiri A, Shoham-Vardi I, Furman B, Hackmon-Ram R, Mazor M. Differences in preterm delivery rates and outcomes in Jews and Bedouins in southern Israel. Eur J Obstet Gynecol Reprod Biol 2000; 93 (1) 41-46
- 72 Coory MD. Comment on: Heterogeneity in meta-analysis should be expected and appropriately quantified. Int J Epidemiol 2010; 39: 932 ; author reply 933
- 73 Rosenberg TJ, Raggio TP, Chiasson MA. A further examination of the “epidemiologic paradox”: birth outcomes among Latinas. J Natl Med Assoc 2005; 97: 550-556
- 74 Landale NS, Gorman BK, Oropesa RS. Selective migration and infant mortality among Puerto Ricans. Matern Child Health J 2006; 10: 351-360
- 75 McGlade MS, Saha S, Dahlstrom ME. The Latina paradox: an opportunity for restructuring prenatal care delivery. Am J Public Health 2004; 94: 2062-2065
- 76 Zambrana RE, Scrimshaw SC, Collins N, Dunkel-Schetter C. Prenatal health behaviors and psychosocial risk factors in pregnant women of Mexican origin: the role of acculturation. Am J Public Health 1997; 87: 1022-1026
- 77 Ravelli AC, Tromp M, Eskes M , et al. Ethnic differences in stillbirth and early neonatal mortality in The Netherlands. J Epidemiol Community Health 2011; 65: 696-701