Cited by 255Maternal and Neonatal HealthcareInfant Development and Preterm CarePreterm Birth and Chorioamnionitis

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What Causes Racial Disparities in Very Preterm Birth? A Biosocial Perspective

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Kramer, M. R., Hogue, C. R.·2009·Epidemiologic Reviews

DOI 10.1093/ajerev/mxp003PMC PMC4361938

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Abstract

Very preterm birth (<32 weeks' gestation) occurs in approximately 2% of livebirths but is a leading cause of infant mortality and morbidity in the United States. African-American women have a 2-fold to 3-fold elevated risk compared with non-Hispanic white women for reasons that are incompletely understood. This paper reviews the evidence for the biologic and social patterning of very preterm birth, with attention to leading hypotheses regarding the etiology of the racial disparity. A systematic review of the literature in the MEDLINE, CINAHL, PsycInfo, and EMBASE indices was conducted. The literature to date suggests a complex, multifactorial causal framework for understanding racial disparities in very preterm birth, with maternal inflammatory, vascular, or neuroendocrine dysfunction as proximal pathways and maternal exposure to stress, racial differences in preconceptional health, and genetic, epigenetic, and gene-environment interactions as more distal mediators. Interpersonal and institutionalized racism are mechanisms that may drive racially patterned differences. Current literature is limited in that research on social determinants and biologic processes of prematurity has been generally disconnected. Improved etiologic understanding and the potential for effective intervention may come with better integration of these research approaches.

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See all 255

Authors: Kramer, M. R., & Hogue, C. R.
Affiliations: Emory University (US)
ORCID: Kramer, M. R.
Venue: Epidemiologic Reviews
Publisher: Oxford University Press (OUP)
Published: 2009-05-28
Volume: 31
Issue: 1
Pages: 84-98
ISSN: 0193-936X (ISSN-L)
1478-6729
DOI: 10.1093/ajerev/mxp003
PMC: PMC4361938
OpenAlex: W2165878225
Semantic Scholar: 5c435a8ed2a37665677d6a381c94333c33843848
Cited by: 255
References: 183
Citations by year: 2026: 4 · 2025: 10 · 2024: 12 · 2023: 11 · 2022: 33 · 2021: 16 · 2020: 21 · 2019: 24 · 2018: 10 · 2017: 17 · 2016: 13 · 2015: 17 · 2014: 9 · 2013: 16 · 2012: 18
FWCI: 2.48
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Epidemiologic Reviews (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
University Libraries (University of Maryland) (submittedVersion)
HighWire Press Open Archive (submittedVersion)
Digital Repository at the University of Maryland (University of Maryland College Park)
Funders: U.S. Public Health Service (T03MC07651)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32HD052460)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
Health Sciences › Medicine › Obstetrics and Gynecology › Preterm Birth and Chorioamnionitis
Keywords: very preterm birth, racial disparities, African American women, biosocial model, maternal inflammation, neuroendocrine dysfunction, maternal stress, epigenetics, gene-environment interaction, institutional racism, interpersonal racism, social determinants of health
MeSH terms: Female, Humans, Infant, Newborn, Pregnancy, Pregnancy Complications, Social Environment, Stress, Psychological, United States, Racial Groups, Premature Birth

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What Causes Racial Disparities in Very Preterm Birth? A Biosocial Perspective

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