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Preterm birth among African American and white women: a multilevel analysis of socioeconomic characteristics and cigarette smoking
Abstract
Study objective: Research shows that neighbourhood socioeconomic factors are associated with preterm delivery. This study examined whether cigarette smoking and individual socioeconomic factors modify the effects of neighbourhood factors on preterm delivery. Design: Case-control study. Setting: Moffit Hospital in San Francisco, California. Participants: 417 African American and 1244 white women, including all preterm and a random selection of term deliveries 1980–1990, excluding non-singleton pregnancies, congenital anomolies, induced deliveries, and women transported for special care. US census data from 1980 and 1990 were used to characterise the women’s neighbourhoods, defined as census tracts. Results: Cigarette smoking increased the risk of preterm delivery among both African American (OR=1.77, 95% confidence intervals (CI) (1.12 to 2.79)) and white women (OR=1.25, 95% CI (1.01 to 1.55)). However, cigarette smoking did not attenuate or modify the association of neighbourhood factors with preterm delivery. Among African American women, having public insurance modified the relation between neighbourhood unemployment and preterm delivery; among women without public insurance, the risk of preterm delivery was low in areas with low unemployment and high in areas with high unemployment, while among women with public insurance the risk of preterm delivery was highest at low levels of neighbourhood unemployment. Conclusions: Cigarette smoking was associated with preterm delivery, especially among African Americans. Adverse neighbourhood conditions had an influence on preterm delivery beyond that of cigarette smoking. The effects of some neighbourhood characteristics were different depending on individual socioeconomic status. Examining socioeconomic and behavioural/biological risk factors together may increase understanding of the complex causes of preterm delivery.
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“Difference-of-coefficients between models was the most common mediation analysis approach”
From Mediators of socioeconomic inequalities in preterm birth: a systematic review (2022) · cites this paper as [44]
In the citing paper
“only six studies assessed exposure-mediator interaction”
From Mediators of socioeconomic inequalities in preterm birth: a systematic review (2022) · cites this paper as [44]
In the citing paper
“Three found no significant association [36, 42, 54], while one found an association for African-American participants only [44].”
From Mediators of socioeconomic inequalities in preterm birth: a systematic review (2022) · cites this paper as [44]
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“Fifteen studies used individual measures of maternal SES, and seven used aggregated measures (e.g. neighbourhood SES) [36–39, 42, 44, 53].”
From Mediators of socioeconomic inequalities in preterm birth: a systematic review (2022) · cites this paper as [44]
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“In one study, the exposure measures were from census data collected 1980–1990, the same time period as the outcome [44].”
From Mediators of socioeconomic inequalities in preterm birth: a systematic review (2022) · cites this paper as [44]
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Cited by
PAN, Y., & JACKSON, R. T. (2008) · Epidemiology and Infection · doi:10.1017/s095026880700831x · Cited by 294
Racial Disparities in Preterm Birth
Culhane, J. F., & Goldenberg, R. L. (2011) · Seminars in Perinatology · doi:10.1053/j.semperi.2011.02.020 · Cited by 196
Messer, L. C., Oakes, J. M., & Mason, S. (2010) · American Journal of Epidemiology · doi:10.1093/aje/kwp435 · Cited by 161
Adverse childhood experiences are associated with spontaneous preterm birth: a case-control study
Christiaens, I., Hegadoren, K., & Olson, D. M. (2015) · BMC Medicine · doi:10.1186/s12916-015-0353-0 · Cited by 130
Socioeconomic Status, Preeclampsia Risk and Gestational Length in Black and White Women
Ross, K. M., Dunkel Schetter, C., McLemore, M. R., Chambers, B. D., Paynter, R. A., Baer, R., Feuer, S. K., Flowers, E., Karasek, D., Pantell, M., et al. (2019) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-019-00619-3 · Cited by 106
Metadata
- Authors
- Ahern, J., Pickett, K. E., Selvin, S., & Abrams, B.
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 2003-07-25
- Volume
- 57
- Issue
- 8
- Pages
- 606-611
- ISSN
- 0143-005X
- 1470-2738
- Cited by
- 113
- References
- 2
- Language
- en
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