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Population-level correlates of preterm delivery among black and white women in the U.S.

CPQCC Publication
TitlePopulation-level correlates of preterm delivery among black and white women in the U.S.
Publication TypeJournal Article
Year of Publication2014
AuthorsCarmichael SL, Cullen MR, Mayo JA, Gould JB, Loftus P, Stevenson DK, Wise PH, Shaw GM
JournalPLoS One
Date Published2014
KeywordsAdult, African Americans, European Continental Ancestry Group, Female, Gestational Age, Humans, Infant, Newborn, Linear Models, Multivariate Analysis, Obstetric Labor, Premature, Pregnancy, Premature Birth, Prevalence, Risk Assessment, Risk Factors, Socioeconomic Factors, United States

OBJECTIVE: This study examined the ability of social, demographic, environmental and health-related factors to explain geographic variability in preterm delivery among black and white women in the US and whether these factors explain black-white disparities in preterm delivery.

METHODS: We examined county-level prevalence of preterm delivery (20-31 or 32-36 weeks gestation) among singletons born 1998-2002. We conducted multivariable linear regression analysis to estimate the association of selected variables with preterm delivery separately for each preterm/race-ethnicity group.

RESULTS: The prevalence of preterm delivery varied two- to three-fold across U.S. counties, and the distributions were strikingly distinct for blacks and whites. Among births to blacks, regression models explained 46% of the variability in county-level risk of delivery at 20-31 weeks and 55% for delivery at 32-36 weeks (based on R-squared values). Respective percentages for whites were 67% and 71%. Models included socio-environmental/demographic and health-related variables and explained similar amounts of variability overall.

CONCLUSIONS: Much of the geographic variability in preterm delivery in the US can be explained by socioeconomic, demographic and health-related characteristics of the population, but less so for blacks than whites.

Alternate JournalPLoS One
PubMed ID24740117
PubMed Central IDPMC3989227