The 130th Annual Meeting of APHA

Abstract #47024

Cynthia Ferre, MPH, Division of Reproductive Health, Centers for Disease Control & Prevention, 4770 Buford Highway, K-23, Atlanta, GA 30341, 770-488-6268, cdf1@cdc.gov and Vijaya K. Hogan, DrPH, Division of Reproductive Health, CDC, 4770 Buford Hwy, NE MS K23, Atlanta, GA 30031.

A goal of Healthy People 2010 is to eliminate health disparities among racial/ethnic populations. Using U.S. 1990-1999 birth certificate data, the authors examined racial/ethnic disparities in singleton preterm delivery (PTD) among low risk women, defined as those with first trimester prenatal care, at least 4 years of college education, and over age 20. The population consisted of non-Hispanic white (10% random sample, n=581,050), African American (n=452,203), Hispanic (n=340,733), Native American (n=16,775), and Asian/Pacific Islander women (n=458,328)]. PTD was examined at 20-31, 32-34, 35-36 weeks gestation. Compared to the general population, low risk women had lower PTD rates, except for Asians at 32-34 weeks (50% increase). To assess population disparities among low risk women, multivariable logistic regression compared each non-white group to white women. The ORs, adjusted for multiple maternal factors, are: African American: 2.7 (at 20-31 weeks); 1.8 (at 32-34 weeks); 1.4 ( at 35-36 weeks). Hispanic: 1.2 (20-31 weeks); 1.3 (32-34 weeks); 1.2 (35-36 weeks). Native American: 1.2 (20-31 weeks); 1.4 (32-34 weeks); 1.2 (35-36 weeks). Asian: 0.9 (20-31 weeks); 1.0 (32-34 weeks); 1.1 (35-36 weeks). While college education and early prenatal care entry are associated with lower PTD rates, these factors are insufficient in explaining disparity. Other social conditions, pre-existing medical conditions, pregnancy complications, and other residual confounding from information unavailable in vital statistics, such as maternal stress and infection, may contribute to the observed differences. Prevention research strategies for improvement of pregnancy outcomes and associated disparities should address pre-pregnancy health.

Learning Objectives: At the conclusion of this presentation, the participant (learner) will be able to

• Describe differences between low-risk women and the general population and to describe racial and ethnic disparities in PTD during the 1990s in the U.S.;
• Articulate the limitations of the current birth certificate in analyzing racial disparities; and
• Discuss the importance of including pre-pregnancy health in prevention research strategies for reducing preterm delivery and associated disparities.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.