Am J Perinatol 2020; 37(13): 1340-1350
DOI: 10.1055/s-0039-1693696
Original Article

A Multisite Examination of Everyday Discrimination and the Prevalence of Spontaneous Preterm Birth in African American and Latina Women in the United States

Kimberly E. Fryer
1  Department of Obstetrics and Gynecology, Division of General Obstetrics and Gynecology, University of South Florida, Tampa, Florida
,
Anissa I. Vines
2  Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Alison M. Stuebe
3  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
4  Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
› Author Affiliations
Funding This secondary analysis was of the Child Community Health Network Study, which was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (U HD44207, U HD44219, U HD44226, U HD44245, U HD44253, U HD54791, U HD54019, U HD44226–05S1, U HD44245–06S1, and R03 HD59584) and the National Institute for Nursing Research (U NR008929).

Abstract

Objective African American women have a higher risk of spontaneous preterm birth than White and Latina women. Although Latina women are exposed to similar social determinants of health, they have lower rates of spontaneous preterm birth. One theory for this difference is the maternal stress biological pathway, whereby lifetime stressors, such as racial discrimination, lead to a premature activation of parturition. We investigated the prevalence of self-reported discrimination and its association with the prevalence of spontaneous preterm birth.

Study Design Using data from the Community Child Health Research Network Study, a multisite cohort study from 2008 to 2012, we conducted a cross-sectional analysis of 1,154 African American women and 578 Latina women.

Results Adjusting for multiple risk factors, African American and Latina women who experienced the highest tertile of discrimination had a higher prevalence of preterm birth compared with those who experienced discrimination less than once per year, adjusted hazard ratio (aHR) = 1.5 (0.7–3.1) and 3.6 (0.9–14.4), respectively.

Conclusion In our cohort, we found a statistically significant association only in the medium discrimination group in Latina women, but we did not find a statistically significant association in African American women. Reduction in experienced discrimination may be an important intervention for reducing adverse pregnancy outcomes.



Publication History

Received: 04 February 2019

Accepted: 07 June 2019

Publication Date:
31 July 2019 (online)

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