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The Relation of Neighborhood Income to the Age-Related Patterns of Preterm Birth Among White and African-American Women: The Effect of Cigarette Smoking

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Abstract

Objectives We investigated the contributions of cigarette smoking to the age-related patterns of preterm (<37 weeks) birth (PTB) rates among African-American and White women within the context of lifelong neighborhood income. Methods Stratified and multilevel logistic regression analyses were performed on an Illinois transgenerational dataset of non-Hispanic White and African-American infants (1989–1991) and their mothers (1956–1976) with appended US census income information. Results: Among non-smoking African-American women (n = 20,107) with a lifelong residence in lower income neighborhoods, PTB rates decreased from 18.5 % for teens to 15.0 % for 30–35 year-olds, p < 0.0001. The opposite pattern occurred among African-American women smokers (n = 5936) with a lifelong residence in lower income neighborhoods, p < 0.01. Among upwardly mobile African-American women smokers (n = 756), PTB rates increased from 11.1 % for teens to 24.9 % for 30–35 year-olds, p < 0.05. Cigarette smoking was not associated with an age-related increase in PTB rates among African-American women with a lifelong residence in upper income neighborhoods. No subgroup of White women, even cigarette smokers with a lifelong residence in lower income neighborhoods, exhibited weathering with regard to PTB. Conclusions A weathering pattern of rising PTB rates with advancing age occurs only among African-American women cigarette smokers with an early-life or lifelong residence in lower income neighborhoods, underscoring the public health policy importance of targeted smoking cessation programs in eliminating the racial disparity in the age-related patterns of PTB rates.

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Authors and Affiliations

  1. Division of Neonatology-#45, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL, 60611, USA

    Shayna Hibbs & James W. Collins Jr.

  2. Department of Epidemiology, University of Illinois School of Public Health, 1200 W. Harrison St., Chicago, IL, 60607, USA

    Kristin M. Rankin

  3. Division of Neonatology, Stroger Hospital of Cook County, 1969 W. Ogden Ave., Chicago, IL, 60612, USA

    Richard J. David

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  1. Shayna Hibbs
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  2. Kristin M. Rankin
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  3. Richard J. David
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  4. James W. Collins Jr.
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Correspondence to James W. Collins Jr..

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Hibbs, S., Rankin, K.M., David, R.J. et al. The Relation of Neighborhood Income to the Age-Related Patterns of Preterm Birth Among White and African-American Women: The Effect of Cigarette Smoking. Matern Child Health J 20, 1432–1440 (2016). https://doi.org/10.1007/s10995-016-1941-0

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