Preterm Birth Among American Indian/Alaskan Natives in Washington and Montana: Comparison with Non-Hispanic Whites

Abstract

Preterm birth is the single most important cause of perinatal mortality in North America. Given that American Indians/Alaskan Natives (AI/ANs) in the United States continue to have adverse birth outcomes, the purpose of this study is to compare the risk of preterm birth among AI/AN mothers to Non-Hispanic White mothers living in Washington and Montana from 2003 to 2009. A population-based retrospective cohort study was conducted examining the association between AI/AN mothers (self-reported) and the risk of preterm birth (gestational age <37 weeks) using birth certificate data from Washington and Montana. All AI/AN singleton lives births (n = 26,648) from residents of Washington and Montana from 2003 to 2009 were identified and included in our study. An identical number of Non-Hispanic White singleton infants (n = 26,648) born to residents of Washington and Montana were randomly selected as a comparison group and logistic regression was used to analyze the data. AI/AN mothers living in Washington and Montana between 2003 and 2009 were 1.34 times (95 % CI 1.25-1.44) as likely to have a preterm birth compared to Non-Hispanic Whites after adjusting for maternal and paternal characteristics as well as pregnancy risk factors. AI/AN mothers residing in Washington and Montana from 2003 to 2009 were at a significantly increased risk of having a preterm birth compared to Non-Hispanic Whites. Identifying etiologic differences in preterm birth experienced by AI/ANs is essential in targeting future interventions.

Pre-eclampsia in American Indians/Alaska Natives and Whites: The Significance of Body Mass Index

“…We initially calculated ORs with adjustment for all covariates except BMI. We adopted this approach because the AI/AN and White populations have very different demographic and socioeconomic characteristics and distinct prenatal smoking patterns (Hwang et al 2013; Amparo et al 2011; Baldwin et al 2009). A subsequent model adjusted for BMI, because average BMI is higher in AI/ANs than in Whites (CDC 2012), and allowed us to examine its unique effect on pre-eclampsia risk.…”

“…Data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) indicate that 33 % of AI/AN women of childbearing age are obese, compared to 20 % of Whites (Denny et al 2002). Additionally, AI/ANs have a higher prevalence of prenatal smoking; lower educational attainment; lower socioeconomic status; and lower rates of prenatal care than their White counterparts (Hwang et al 2013). Given that AI/AN women of childbearing age exhibit a higher prevalence of several risk factors for pre-eclampsia, relative to Whites (Lisonkova et al 2013), we hypothesized that AI/ANs would be at increased risk of pre-eclampsia.…”

The Association Between Diabetes Mellitus Among American Indian/Alaska Native Populations with Preterm Birth in Eight US States from 2004–2011

“…These conditions have resulted in poor health outcomes, such as higher incidence of diabetes and obesity in AI/AN populations. Simultaneously, AI/AN women have a higher incidence of preterm birth compared to other populations in the United States [17].…”

Associação entre raça/cor da pele e parto prematuro: revisão sistemática com meta-análise

“…Only in the study of Hwang et al 31 the majority of the participants were below 18 years old. As there was an adjustment of this covariate in this study, it is believed that it did not influence the results of this meta-analysis.…”