Document Detail

Racial and ethnic disparities in preterm birth: the role of stressful life events.
MedLine Citation:
PMID:  15467527     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The purpose of this study was to examine racial-ethnic disparities in stressful life events before and during pregnancy and to assess the relationship between stressful life events and racial-ethnic disparities in preterm birth. STUDY DESIGN: Using data from the Pregnancy Risk Assessment Monitoring System, we conducted a retrospective cohort analysis of a sample of 33,542 women from 19 states who were delivered of a live-born infant in 2000. Principal component analysis was used to group 13 stressful life events into 4 stress constructs: emotional, financial, partner-related, and traumatic. Racial-ethnic disparities in stressful life events were assessed with the use of bivariate and multivariate regression analyses. The contribution of stressful life events to racial-ethnic disparities in preterm birth was evaluated with the use of stepwise regression model and interaction terms. RESULTS: Black women and American Indian/Alaska Native women reported the highest number of stressful life events in the 12 months before delivery. Compared with non-Hispanic white women, black women were 24% more likely to report emotional stressors, 35% more likely to report financial stressors, 163% more likely to report partner-related stressors, and 83% more likely to report traumatic stressors. The addition of stress constructs to the stepwise regression model minimally affected the association between race-ethnicity and preterm birth, and none of the stress constructs were significantly associated with preterm birth. There were no significant interaction effects between race-ethnicity and stress on preterm birth, except for a modest effect between black race and traumatic stressors. CONCLUSION: There are significant racial-ethnic disparities in the experience of stressful life events before and during pregnancy. Stressful life events do not appear to contribute significantly to racial-ethnic disparities in preterm birth.
Michael C Lu; Belinda Chen
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  191     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-10-06     Completed Date:  2004-11-06     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  691-9     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, Calif, USA.
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MeSH Terms
African Continental Ancestry Group / statistics & numerical data
Asian Americans / statistics & numerical data
Continental Population Groups*
Ethnic Groups / statistics & numerical data*
European Continental Ancestry Group / statistics & numerical data
Health Surveys
Hispanic Americans / statistics & numerical data
Indians, North American / statistics & numerical data
Infant, Newborn
Infant, Premature*
Obstetric Labor, Premature / epidemiology*
Regression Analysis
Stress, Psychological / complications,  epidemiology*
Wounds and Injuries / complications,  epidemiology
Grant Support
5U93MC00099//PHS HHS; HD01281-03/HD/NICHD NIH HHS

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