Disproportionate Preterm Delivery Among Black Women: a State-Level Analysis
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Preterm delivery occurs at extraordinarily higher rates among Black women than among women of any other race or ethnicity. For those children who survive, many face a lifetime of health and developmental challenges as well as difficulties in school and life. Previous studies have provided substantive evidence that the preterm delivery disparity experienced by Black women is associated with ongoing distress caused by racism. Our study examines rates of preterm delivery for Black women in the USA to determine the level of risk associated with living in specific states. Using a logistic regression model, we examined the impact of the delivery state, controlling for known clinical, economic, and demographic risk factors. We found that 32 of the 35 states included in our analysis were associated with a statistically significantly increased risk of preterm delivery among Black women, as compared to the state with the lowest preterm delivery rate for Black women. These findings allowed us to organize states into a continuum of preterm delivery risk. Because of the harmful effects of preterm delivery and its disproportionate impact among Black women and infants, we recommend that a measure of preterm delivery be included in any state plan to assess, intervene in, and monitor racial disparities.
KeywordsLabor and delivery Disparities Preterm delivery Social determinants of health MSC Codes: 92-02: Research exposition (monographs, survey articles), Biology and other natural sciences
The authors would like to thank the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics for providing the data used in this study.
All the authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Palmira Santos, Gitanjali Joglekar, and Kristen Faughnan. The first draft of the manuscript was written by Palmira Santos, and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical approval was not required for this retrospective study. This article does not contain any studies with animals performed by any of the authors.
Formal consent is not required for this type of study.
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