Preterm Delivery and Low Birth Weight among First-Born Infants of Black and White College Graduates

Abstract

Reproductive outcomes were investigated in black and white female college graduates, presumed to be of similar socioeconomic status and similar risk profile with respect to environmental factors. Data were gathered by mail survey from graduates (1973-1985) of four Atlanta, Georgia, colleges between February and June 1988. Of 6,867 alumnae to whom questionnaires were mailed, 3,084 responded. A follow-up study of black nonrespondents yielded responses from 14% (335) of those who did not respond to the mail survey. For all graduates with a first live born at the time of survey (n = 1,089), the rates of preterm delivery, low birth weight, and infant mortality were 80.8, 82.6, and 14.6 per thousand births (primigravida), respectively. Compared with white graduates, black graduates had 1.67 times the risk of preterm delivery and 2.48 times the risk of low birth weight. Measures of social and economic status differed significantly by race. However, adjustment for these variables did not reduce the estimated risk for black graduates compared with whites. Analysis of the nonresponder survey suggested that respondent data alone overestimates the incidence of adverse outcomes in blacks; using nonresponder data, relative risks of 1.28 (preterm delivery) and 1.75 (low birth weight) were calculated as lower limits of the increased risk for blacks.

Race‐based job discrimination, disparities in job control, and their joint effects on health

“…A fivefold difference is apparent between Black and White participants. While the health effects of racial discrimination have been well-described [Curtis et al, 1997;Williams et al, 1997;DinDzietham et al, 2004;Hurtado et al, 2012], this pathway appears to obviate the effect of education on health entirely in Blacks, and thus may provide at least a partial explanation for decreasing returns in health from increased education that have been described in African-Americans for over two decades [McGrady et al, 1992;Collins and Butler, 1997;Collins et al, 2004;Farmer and Ferraro, 2005;Meyer et al, 2010].…”

The vaginal microbiome, vaginal anti‐microbial defence mechanisms and the clinical challenge of reducing infection‐related preterm birth

“…Even after controlling for socioeconomic and lifestyle variables, the preterm birth rate and neonatal mortality in the USA are higher in black, than in white women. 11,12 Furthermore, maternal infection has been shown to be associated with preterm delivery in black women to a greater extent than in white women. 13 Evidence has been presented that genetic variants that were selected during evolution as being favourable to birth outcome among black women living in areas with prevalent endogenous infections may place them at a disadvantage and increase susceptibility to infection-related preterm birth following their relocation to regions with a low infection rate.…”

Histologic Chorioamnionitis and Preterm Delivery

“…Women were enrolled in gestational weeks 15 through 27 (87 percent before week 25). Inclusion criteria were singleton pregnancy with no known congenital anomaly, maternal age of 15 or more years, maternal serum alphafetoprotein screen in gestational weeks [15][16][17][18][19][20][21][22], no prepregnancy diabetes mellitus, and proficiency in English. The study received approval from institutional review boards at Michigan State University, Michigan Department of Community Health, and nine community hospitals.…”