Risk for spontaneous preterm birth among inter-racial/ethnic couples*. (4th March 2018)

• Record Type: Journal Article
• Authors: Shachar, Bat Zion; Mayo, Jonathan A.; Lyell, Deirdre J.; Stevenson, David K.; Shaw, Gary M.; Blumenfeld, Yair J.
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 31:Number 5(2018)
• Page Start: 633
• Page End: 639
• Publication Date: 2018-03-04
• Subjects: Interracial/ethnic couples -- spontaneous preterm birth -- paternal race/ethnicity; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2017.1293029
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective: Approximately 10% of US couples are inter-racial/ethnic. Substantial variation in preterm birth (PTB) rates is seen when stratified by race/ethnicity, although most studies focused solely on maternal racial/ethnic demographics. Our aims were to analyze the contribution of paternal in addition to maternal race/ethnicity, and to evaluate risk of spontaneous PTB for previously understudied inter-racial/ethnic couples. Methods: California singleton live births from 2007 to 2010 were included. Race/ethnicity was determined based on self-report, obtained from birth certificates and defined as African American (AA), Hispanic, Asian, and White. Logistic regression was used to estimate odds ratios of spontaneous PTB at 20–23, 24–31, 32–36 and <37 weeks of gestation, with White–White couples as reference. Results were stratified by previous PTB, pre-gestational and gestational diabetes and hypertension. To investigate the paternal contribution to the risk for any given maternal race/ethnicity we assessed the rates of PTB among inter-racial/ethnic couples compared to the respective same-race couple. Odds ratios were adjusted for maternal age, parity, BMI, prenatal care, payor status, education and smoking. Results: Among 1, 664, 939 live births, 13% ( n = 216, 417) were born to inter-racial/ethnic couples. Compared to White–White couples, risk for spontaneous PTB was increased across all inter-racial/ethnic couples with a non-White mother, except when the father was Asian. Patterns of association were similar after stratification by previous PTB, hypertension and diabetes. Paternal race/ethnicity was also a significant risk factor for PTB. Conclusions: Increased risks for spontaneous PTB were seen in most inter-racial/ethnic couple groupings. In addition to maternal race/ethnicity, paternal race/ethnicity was a significant risk factor in many inter-racial/ethnic couplings. Identifying such different risk profiles based on both maternal and paternal race/ethnicity may offer new lines of research inquiry for the underlying etiologies of PTB.