Racial disparities in recurrent preterm delivery risk: mediation analysis of prenatal care timing
-
Khalidha Nasiri
,
Erica E. M. Moodie
Abstract
Objectives
We estimated the degree to which the association between race and spontaneous recurrent preterm delivery is mediated by the timing of the first prenatal care visit.
Methods
A retrospective population-based cohort study was conducted using the U.S. National Center for Health Statistics Natality Files. We identified 644,576 women with a prior PTB who delivered singleton live neonates between 2011 and 2017. A mediation analysis was conducted using log-binomial regression to evaluate the mediating effect of timing of first prenatal care visit.
Results
During the seven-year period, 349,293 (54.2%) White non-Hispanic women, 131,296 (20.4%) Black non-Hispanic women, 132,367 (20.5%) Hispanic women, and 31,620 (4.9%) Other women had a prior preterm delivery. The risk of late prenatal care initiation was higher in Black non-Hispanic women, Hispanic women, and Other women (women of other racial/ethnic backgrounds) compared to White non-Hispanic women, and the risk of preterm delivery was higher in women with late prenatal care initiation. Between 8 and 15% of the association between race and spontaneous recurrent preterm delivery acted through the delayed timing of the first prenatal care visit.
Conclusions
Racial disparities in spontaneous recurrent preterm delivery rates can be partly, but not primarily, attributed to timing of first prenatal care visit.
Acknowledgments
Khalidha Nasiri received funding from the Canadian Institutes of Health Research – Frederick Banting and Charles Best Canada Graduate Scholarship in support of her Master’s research. They were not involved in study design, collection, analysis and interpretation of the data, report writing, and in the decision to submit the article for publication.
Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Khalidha Nasiri received funding from the Canadian Institutes of Health Research – Frederick Banting and Charles Best Canada Graduate Scholarship in support of her Master’s research. They were not involved in study design, collection, analysis and interpretation of the data, report writing, and in the decision to submit the article for publication. All other authors state no conflict of interest.
Ethical approval: The Research Ethics Committee at the authors’ institution considered this study exempt from ethical approval because it is based on publicly available data.
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Supplementary Material
The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2020-0133).
© 2020 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- In Memorian
- Robert L. Brent, MD, PhD (1927–2021)
- Review
- Implications of the vaginal microbiome and potential restorative strategies on maternal health: a narrative review
- Original Articles – Obstetrics
- Disorders of placental villous maturation are present in one-third of cases with spontaneous preterm labor
- Gestational iron deficiency anemia is associated with preterm birth, fetal growth restriction, and postpartum infections
- Women with high plasma levels of PBDE-47 are at increased risk of preterm birth
- Racial disparities in recurrent preterm delivery risk: mediation analysis of prenatal care timing
- Doppler ultrasonography of the uterine artery in correlation with KANET
- The cumulative impact of parity on the body mass index (BMI) in a non-selected Lower Saxony population
- The relation between second-trimester placental elasticity and poor obstetric outcomes in low-risk pregnancies
- Comparison of pregnancy outcomes after second trimester amniocentesis between procedures performed by experts and non-experts
- Effect of vitamin D3 supplementation during pregnancy on high risk factors — a randomized controlled trial
- Educating future professionals in perinatal medicine: the attitude of medical and nursing students towards childbirth
- Original Articles – Fetus
- Normal values of cardiac axis (CA) measurements in healthy fetuses during the first trimester screening ultrasound
- Original Articles – Neonates
- Effects of COVID-19 pandemic on breastfeeding rates in a neonatal intensive care unit
- Factors associated with extubation failure in very low birth weight infants: a cohort study in the northeast Brazil
- Perinatal outcome of in vitro fertilization pregnancies in women with polycystic ovary syndrome by pregravid BMI
- Evaluation of audio-voice guided application for neonatal resuscitation: a prospective, randomized, pilot study
- Letter to the Editor
- Systematic screening for SARS-CoV-2 in pregnant women admitted for delivery: not as easy as it sounds
Artikel in diesem Heft
- Frontmatter
- In Memorian
- Robert L. Brent, MD, PhD (1927–2021)
- Review
- Implications of the vaginal microbiome and potential restorative strategies on maternal health: a narrative review
- Original Articles – Obstetrics
- Disorders of placental villous maturation are present in one-third of cases with spontaneous preterm labor
- Gestational iron deficiency anemia is associated with preterm birth, fetal growth restriction, and postpartum infections
- Women with high plasma levels of PBDE-47 are at increased risk of preterm birth
- Racial disparities in recurrent preterm delivery risk: mediation analysis of prenatal care timing
- Doppler ultrasonography of the uterine artery in correlation with KANET
- The cumulative impact of parity on the body mass index (BMI) in a non-selected Lower Saxony population
- The relation between second-trimester placental elasticity and poor obstetric outcomes in low-risk pregnancies
- Comparison of pregnancy outcomes after second trimester amniocentesis between procedures performed by experts and non-experts
- Effect of vitamin D3 supplementation during pregnancy on high risk factors — a randomized controlled trial
- Educating future professionals in perinatal medicine: the attitude of medical and nursing students towards childbirth
- Original Articles – Fetus
- Normal values of cardiac axis (CA) measurements in healthy fetuses during the first trimester screening ultrasound
- Original Articles – Neonates
- Effects of COVID-19 pandemic on breastfeeding rates in a neonatal intensive care unit
- Factors associated with extubation failure in very low birth weight infants: a cohort study in the northeast Brazil
- Perinatal outcome of in vitro fertilization pregnancies in women with polycystic ovary syndrome by pregravid BMI
- Evaluation of audio-voice guided application for neonatal resuscitation: a prospective, randomized, pilot study
- Letter to the Editor
- Systematic screening for SARS-CoV-2 in pregnant women admitted for delivery: not as easy as it sounds
