Preterm Birth and Gestational Length in Four Race–Nativity Groups, Including Somali Americans

Oliver, Emily A.; Klebanoff, Mark A.; Yossef-Salameh, Lina; Oza-Frank, Reena; Moosavinasab, Soheil; Reagan, Patricia B.; Muglia, Louis J.; Buhimschi, Catalin S.; Buhimschi, Irina A.

doi:10.1097/aog.0000000000002427

Cited by 16 publications

(19 citation statements)

References 21 publications

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“…[41][42][43] Immigrant African women are less likely to give birth preterm than native-born black women. 44,45 All of these findings illustrate the potential role of epigenetics in preterm birth. However, genetic and epigenetic studies must include people of diverse ancestry.…”

Section: Increased Riskmentioning

confidence: 78%

The color of health: how racism, segregation, and inequality affect the health and well-being of preterm infants and their families

et al. 2019

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Racism, segregation, and inequality contribute to health outcomes and drive health disparities across the life course, including for newborn infants and their families. In this review, we address their effects on the health and well-being of newborn infants and their families with a focus on preterm birth. We discuss three causal pathways: increased risk; lower-quality care; and socioeconomic disadvantages that persist into infancy, childhood, and beyond. For each pathway, we propose specific interventions and research priorities that may remedy the adverse effects of racism, segregation, and inequality. Infants and their families will not realize the full benefit of advances in perinatal and neonatal care until we, collectively, accept our responsibility for addressing the range of determinants that shape long-term outcomes.

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Section: Increased Riskmentioning

confidence: 78%

The color of health: how racism, segregation, and inequality affect the health and well-being of preterm infants and their families

et al. 2019

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“…Prior publications regarding pregnancies in the Somali population have been reported from the states of Washington, Ohio and Minnesota 1,2,21 . Work from the states of Washington and Ohio discusses increased rates of late term and post-term births among Somali women, with contradictory data regarding neonatal outcomes and fetal deaths 1,2,22 . Adverse outcomes have been documented among Somali women having post term births 1,2 .…”

Section: Somali : Hispanicmentioning

confidence: 99%

“…Work from the states of Washington and Ohio discusses increased rates of late term and post-term births among Somali women, with contradictory data regarding neonatal outcomes and fetal deaths 1,2,22 . Adverse outcomes have been documented among Somali women having post term births 1,2 . The Washington State study reported increased risk for adverse obstetrical and neonatal outcomes compared with both Black and white newborns 2 .…”

Section: Somali : Hispanicmentioning

confidence: 99%

“…In a recent large epidemiologic study from Ohio that included almost 2,000,000 births from 2000-2015, rates of post term delivery after 42 weeks were increased vefold among Somali women compared with all other ethnicities including African born women from West Africa 1 . This trend was maintained even after controlling for spontaneous or induced labor, smoking and parity 1 . It is not clear if this is associated with the observed increased perinatal morbidity and mortality reported for all immigrant Black women 7 .…”

Section: Introductionmentioning

confidence: 99%

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Population Based Cohort Study of Fetal Deaths, and Neonatal and Perinatal Mortality at Term Within a Somali Diaspora

Contag

Nardos

Buhimschi

et al. 2021

Preprint

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Background: Delivery among Somali women occurs later, we have no information on the associated perinatal mortality. Our objective is to compare perinatal mortality among Somali women with the population rates.Methods: This is a retrospective cohort study 2011-2017. Information was obtained from certificates of birth, neonatal and fetal death through data use agreement signed between the Minnesota Department of Health and the University of Minnesota. Data derived from 470,550 non-anomalous births >20 weeks of gestation in Minnesota 2011-2017. We included all U.S. born White, U.S. born Black, women born in Somalia or self-identified as Somali, and women who identified as Hispanic regardless of place of birth (377,426), and excluded births <37 weeks and >42 weeks, > 1 fetus, age <18 or >45 years, or women of other ethnicities. The exposure was documented ethnicity or place of birth, and the outcomes were live birth, fetal death, neonatal death prior to 28 days, and perinatal mortality rates. These were calculated using binomial proportions with 95% confidence intervals and compared using odds ratios (aOR) adjusted for diabetes, hypertension and maternal body mass index.Results: The aOR for fetal and neonatal death in the Somali cohort was greater than for U.S. born White (aOR, 2.05 [95%CI: 1.49 - 2.83], aOR 1.84 [95%CI: 1.36 - 2.48]) and Hispanic women (aOR, 1.90 [95%CI: 1.30 - 2.79] and 1.47 [95%CI: 1.05 - 2.06] respectively). Limiting the analysis to those with spontaneous onset of labor (SOL) did not modify the results. This effect persisted up to 41 weeks after which the risk was similar to that of U.S. born White women but lower than for U.S. born Black women and Hispanic women.Conclusions: Despite greater mean gestational age, Somali fetal death rates are similar to population rates. Neonatal mortality is increased compared with White women, but similar to that of other minorities in Minnesota. Somali neonatal mortality decreased and was comparable to that of the White population after 41 weeks.

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“…Women of African ancestry are also twice as likely to receive a clinical diagnosis of BV, and analyses of the vaginal microbiota reveal that they are more likely to be colonized by certain BV-associated bacteria 19 . Furthermore, African American women (though not African-born women) are nearly twice as likely to give birth preterm (<37 weeks gestation) and more than twice as likely to give birth early preterm (<34 weeks) 20,21 and vitamin D deficiency has been linked to preterm birth and small-for-gestational-age infants born to women of African ancestry 22,23 . There is an urgent need to understand and address these important health disparities and an important first step in understanding whether or not the three parameters, vitamin D status, vaginal microbiome, and preterm birth, are linked.…”

Section: Introductionmentioning

confidence: 99%

Relationship between vitamin D status and the vaginal microbiome during pregnancy

et al. 2019

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Objective: Evidence supports an inverse association between vitamin D and bacterial vaginosis (BV) during pregnancy. Furthermore, both the vaginal microbiome and vitamin D status correlate with pregnancy outcome. Women of African ancestry are more likely to experience BV, to be vitamin D deficient, and to have certain pregnancy complications. We investigated the association between vitamin D status and the vaginal microbiome. Study Design: Subjects were assigned to a treatment (4 400 IU), or a control group (400 IU vitamin D daily), sampled 3 times during pregnancy, and vaginal 16S rRNA profiles and plasma 25-hydroxyvitamin D [25(OH)D] concentrations were examined. Result: Gestational age and ethnicity were significantly associated with the microbiome. Megasphaera correlated negatively (p = 0.0187) with 25(OH)D among women of African ancestry. Among controls, women of European ancestry exhibited a positive correlation between plasma 25(OH)D and L. crispatus abundance. Conclusion: Certain vaginal bacteria are associated with plasma 25(OH)D concentration.

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Preterm Birth and Gestational Length in Four Race–Nativity Groups, Including Somali Americans

Cited by 16 publications

References 21 publications

The color of health: how racism, segregation, and inequality affect the health and well-being of preterm infants and their families

The color of health: how racism, segregation, and inequality affect the health and well-being of preterm infants and their families

Population Based Cohort Study of Fetal Deaths, and Neonatal and Perinatal Mortality at Term Within a Somali Diaspora

Relationship between vitamin D status and the vaginal microbiome during pregnancy

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