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326356
Impact of Gestational Age Measure on Disparities in Preterm Birth Rates among Hispanic Subgroups


Wednesday, November 4, 2015

Melissa Gambatese, MPH, Perinatal Data Center, March of Dimes, White Plains, NY
Rebecca Russell, MSPH, Perinatal Data Center, March of Dimes, White Plains, NY
Kate Disare, MPH, Epidemiology, Perinatal Data Center, March of Dimes, White Plains, NY
Todd Dias, MS, Perinatal Data Center, March of Dimes, White Plains, NY
Gerard Carrino, PhD, MPH, Program Resource Development and Evaluation, March of Dimes, White Plains, NY
  
Problem/Relevance: Racial/ethnic disparities in US PTB rates based on last menstrual period (LMP) are well documented, with higher rates among Hispanic women compared to non-Hispanic whites. However, PTB rates can vary substantially depending on gestational age measure, with LMP rates typically higher than obstetric estimate (OE) rates. The National Center for Health Statistics (NCHS) will transition to OE with 2014 data, making it important to understand the impact of this transition on the measurement of PTB risks among Hispanic populations. 

Methods: We analyzed the 2013 NCHS natality file (births 17-47 weeks) and calculated LMP- and OE-PTB rates (<37 weeks) and OE relative risks (OE-RR) stratified by maternal race/ethnicity. Among Hispanics, we further stratified by mother’s country of origin and state of residence.

Results: The Hispanic OE-PTB rate was only slightly higher than whites (9.1% vs. 8.9%, P<0.001), yet disparities by Hispanic country of origin remained. OE-PTB rates ranged from 10.9% among Puerto Ricans to 8.7% among Central/South Americans. The OE-RR among Puerto Ricans was 20% higher than whites (RR=1.2, P<0.001). The largest disparity among Mexicans was in Arizona (RR=1.1, P<0.001) where 92% of Hispanic births were to mothers of Mexican origin. Data on other states will also be presented.

Conclusions: The transition to OE results in similar PTB rates among Hispanics and whites, yet risks for certain Hispanic subgroups remain elevated and vary by state. Health professionals working to reduce PTB among the Hispanic community should consider these findings in their work to improve the health of Hispanic mothers and babies.

Learning Areas:

Diversity and culture
Epidemiology
Public health or related research

Learning Objectives:
Assess differences between last menstrual period- and obstetric estimate-preterm birth rates, specifically among Hispanic women. Compare differences in preterm birth rates by mother’s Hispanic country of origin. Evaluate state-specific differences in relative risks of preterm birth by mother’s Hispanic country of origin.

Keyword(s): Latinos, MCH Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working as a maternal and child health epidemiologist for several years with the March of Dimes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5013.0: Poster: Health disparities