IntroductionInfants born alive <37 weeks are classified as premature. The global estimate of preterm birth in 2014 was 10.6%, and it is the leading cause of death of children under the age of 5 years. Preterm birth disproportionately affects women of minority populations, yet knowledge about the incidence and associated outcomes among Pacific Islanders is limited. The objectives of this scoping review are to identify studies that describe risk factors, maternal-child health outcomes and existing interventions to prevent preterm birth among Pacific Islanders, and to summarise the barriers and facilitators to decrease the burden.Methods and analysisWe will follow the Joanna Briggs Institute Manual for Evidence Synthesis for scoping reviews and the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) to conduct this scoping review. The Covidence web application will be used for data management and consensus review. We will search on MEDLINE ALL (Ovid), EMBASE (Ovid), Web of Science Core Collection (as licensed at Yale), the Cochrane Library, CINAHL (EBSCOhost) and two non-indexed regional journals (Pacific Journal of Reproductive Health and Pacific Health Dialog). Title-abstract and full-text screening of eligible studies will be performed by two authors, and data will be extracted by the first author. Outcomes extracted will be presented using evidence mapping.Ethics and disseminationFindings will drive suggestions for new data collection needed to fill knowledge gaps and improve future study designs to decrease the burden of preterm birth among Pacific Islanders. There are no ethical concerns. This protocol will be disseminated in related peer-reviewed journals.

Objective To better understand the epidemiology of preterm birth among Pacific Islanders in the United States and the US‐Affiliated Pacific Islands. Methods Systematic searches of MEDLINE, Embase, CINAHL, PsycINFO, two nonindexed regional journals, and gray literature were conducted and finalized in September 2021. Observational studies published since January 2010 that documented preterm birth outcomes among Pacific Islanders in the United States and the US‐Affiliated Pacific Islands were eligible for inclusion. Outcomes of interest included preterm birth prevalence, risk compared with white women, and risk factors for preterm birth among Pacific Islanders. Results Fourteen of the 3183 screened articles were included in meta‐analyses. Random‐effects models were used for pooled estimates with 95% confidence intervals. The pooled prevalence of preterm birth among Pacific Islanders was 11.2%, 95% CI: 9.3%‐13.6%. Marshallese women had the highest pooled prevalence (20.7%, 95% CI 18.6%‐23.0%) among Pacific Islander subgroups. Compared with white women, Pacific Islander women had higher odds of experiencing preterm birth (OR = 1.40, 95% CI: 1.28‐1.53). Four risk factors for preterm birth could be explored with the data available: hypertension, diabetes, smoking, and pre‐pregnancy body mass index; hypertension and diabetes significantly increased the odds of preterm birth. Conclusions Existing literature suggests that United States Pacific Islanders were more likely to experience preterm birth than white women, although the pooled prevalence varied by Pacific Islander subgroup. Data support the need for disaggregation of Pacific Islanders in future research and argue for examination of subgroup‐specific outcomes to address perinatal health disparities.

This cohort study assesses 5-year race-stratified neonatal mortality and prevalence of preterm births in the US using birth-based and fetuses-at-risk approaches.

Objective: To characterize prevalence and persistence of anaemia among Samoan children over a two-three-year period. Design: Data were from two consecutive waves (2015 and 2017/2018) of the Ola Tuputupua’e “Growing up” study. Anaemia (haemoglobin <11·0 or 11·5 g/dL for 2-4 and ≥5 years olds, respectively) was considered “transient” when it occurred at only one wave or “persistent” if it was present at two consecutive waves. Child, maternal, and household correlates of anaemia were examined using log-binomial and modified Poisson regressions. Setting: Eleven Samoan villages Participants: Mother-child pairs (n=257) recruited in 2015 and re-assessed in 2017/2018. Results: Anaemia prevalence was 33·9% in 2015 and 28·0% in 2017/2018; 35·6% of cases identified in 2015 were persistent. Risk of anaemia at only one wave was lower among children who were older in 2015 (age 4 vs. 2 years, aRR=0·54, 95% CI:0·35-0·84, P=0·007), had older mothers (≥40 vs. 18-29 years, aRR=0·61, 95% CI:0·39-0·95, P=0·029), and had higher daily sodium intake (for every 100 mg/day, aRR=0·97, 95% CI:0·95-0·99, P=0·003) than children with no anaemia. Children whose anaemia persisted were more likely to have had a mother with anaemia (aRR=2·13, 95% CI:1·17-3·89, P=0·013) and had higher daily dietary iron intake (for every 10 mg/day, aRR=4·69, 95% CI:1·33-16·49, P=0·016) than those with no anaemia. Conclusions: Alongside broadly targeted prevention efforts, which are warranted given the moderate-high anaemia prevalence observed, specific attention should be paid to children with risk factors for persistent anaemia. Routine screening of children whose mothers have anaemia should be encouraged.

The epidemiology of preterm birth among Pacific Islanders is minimally understood. The purpose of this study was to estimate pooled prevalence of preterm birth among Pacific Islanders and to estimate their risk of preterm birth compared to White/European women. We searched MEDLINE, EMBASE, Web of Science Core Collection, Cochrane Library, CINAHL, Global Health, and two regional journals in March 2023. Observational studies were included if they reported preterm birth-related outcomes among Pacific Islanders. Random-effects models were used to estimate the pooled prevalence of preterm birth with 95% confidence interval (CI). Bayes meta-analysis was conducted to estimate pooled odds ratios (OR) with 95% highest posterior density intervals (HPDI). The Joanna Briggs Institute checklists were used for risk of bias assessment. We estimated preterm birth prevalence among Pacific Islanders in the United States (US, 11.8%, sample size [SS] = 209,930, 95% CI 10.8%-12.8%), the US-Affiliated Pacific Islands (USAPI, SS = 29,036, 6.7%, 95% CI 4.9%-9.0%), New Zealand (SS = 252,162, 7.7%, 95% CI 7.1%-8.3%), Australia (SS = 20,225, 6.1%, 95% CI 4.2%-8.7%), and Papua New Guinea (SS = 2,647, 7.0%, 95% CI 5.6%-8.8%). Pacific Islanders resident in the US were more likely to experience preterm birth compared to White women (OR = 1.45, 95% HPDI 1.32–1.58), but in New Zealand their risk was similar (OR = 1.00, 95% HPDI 0.83–1.16) to European women. Existing literature indicates that Pacific Islanders in the US had a higher prevalence of preterm birth and experienced health inequities. Learning from New Zealand’s culturally-sensitive approach to health care provision may provide a starting point for addressing disparities. The limited number of studies identified may contribute to higher risk of bias and the heterogeneity in our estimates; more data is needed to understand the true burden of preterm birth in the Pacific region.