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Cited by 89Racial and Ethnic Identity ResearchMaternal and Neonatal HealthcareMaternal Mental Health During Pregnancy and Postpartum

Experiences of racism and preterm birth: findings from a pregnancy risk assessment monitoring system, 2004 through 2012

Bower, Kelly M., Geller, Ruth J., Perrin, Nancy A., Alhusen, Jeanne·2018·Women's Health Issues
DOI 10.1016/j.whi.2018.06.002
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Abstract

Background Racial disparities in birth outcomes represent a significant public health concern in the United States. Factors associated with racism have been posited as a mechanism underlying these disparities. Yet, findings from previous studies are mixed and based on small, geographically limited samples. This study aims to examine the relationship between experiences of racism and preterm birth in a population-based sample and to explore the role of adequacy of prenatal care within that relationship.Methods Data from the 2004 through 2012 Pregnancy Risk Assessment Monitoring System were analyzed. The sample included non-Hispanic Black mothers from 11 states and New York City who delivered neonates from 2004 to 2012 (n = 11,582). Survey-weighted regression analyses were used to examine the association between women feeling upset by experiences of racism in the 12 months before delivery and subsequent preterm birth. Adequacy of prenatal care was tested as an effect modifier.Results Feeling upset by experiences of racism was significantly associated with greater odds of preterm birth (adjusted odds ratio, 1.29; 95% CI, 1.04-1.59). Results from interaction models revealed that the associations of experiences of racism with preterm birth differed by level of prenatal care, although the interaction term was not significant.Conclusions Findings suggest that, for non-Hispanic Black women, the emotional effect of experiences of racism may contribute to the risk of preterm birth. Future studies should consider the role of adequate prenatal care in this relationship. Racism is an important public health problem with a measurable impact on preterm birth and should be addressed to eliminate racial inequities in birth outcomes.

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Authors
Bower, K. M., Geller, R. J., Perrin, N. A., & Alhusen, J.
Affiliations
  • Johns Hopkins University (US)
  • University of Virginia (US)
Corresponding author
Bower, Kelly M.
ORCID
Venue
Women's Health Issues
Publisher
Elsevier BV
Published
2018-11
Volume
28
Issue
6
Pages
495-501
ISSN
1049-3867 (ISSN-L)
DOI
10.1016/j.whi.2018.06.002
OpenAlex
W2884373751
Cited by
89
References
30
Citations by year
2026: 10 · 2025: 7 · 2024: 12 · 2023: 13 · 2022: 21 · 2021: 18 · 2020: 4 · 2019: 4
FWCI
14.79
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Women s Health Issues (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (KL2TR001077)
  • National Institute of Nursing Research (K23NR015810)
  • National Center for Advancing Translational Sciences
Topics
  • Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords
racism, preterm birth, racial disparities in birth outcomes, non-Hispanic Black women, prenatal care adequacy, Pregnancy Risk Assessment Monitoring System
MeSH terms
Adult, Black or African American, Cross-Sectional Studies, Discrimination, Psychological, Emotions, Female, Humans, Infant, Newborn, Mothers, Population Surveillance, Pregnancy, Prenatal Care, United States, Risk Assessment, Racial Groups, Premature Birth, Health Status Disparities, Racism

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