Hibbs Shayna, Rankin Kristin M, David Richard J, Collins James W
Division of Neonatology-#45, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL, 60611, USA.
Department of Epidemiology, University of Illinois School of Public Health, 1200 W. Harrison St., Chicago, IL, 60607, USA.
Matern Child Health J. 2016 Jul;20(7):1432-40. doi: 10.1007/s10995-016-1941-0.
Objectives We investigated the contributions of cigarette smoking to the age-related patterns of preterm (<37 weeks) birth (PTB) rates among African-American and White women within the context of lifelong neighborhood income. Methods Stratified and multilevel logistic regression analyses were performed on an Illinois transgenerational dataset of non-Hispanic White and African-American infants (1989-1991) and their mothers (1956-1976) with appended US census income information.
Among non-smoking African-American women (n = 20,107) with a lifelong residence in lower income neighborhoods, PTB rates decreased from 18.5 % for teens to 15.0 % for 30-35 year-olds, p < 0.0001. The opposite pattern occurred among African-American women smokers (n = 5936) with a lifelong residence in lower income neighborhoods, p < 0.01. Among upwardly mobile African-American women smokers (n = 756), PTB rates increased from 11.1 % for teens to 24.9 % for 30-35 year-olds, p < 0.05. Cigarette smoking was not associated with an age-related increase in PTB rates among African-American women with a lifelong residence in upper income neighborhoods. No subgroup of White women, even cigarette smokers with a lifelong residence in lower income neighborhoods, exhibited weathering with regard to PTB. Conclusions A weathering pattern of rising PTB rates with advancing age occurs only among African-American women cigarette smokers with an early-life or lifelong residence in lower income neighborhoods, underscoring the public health policy importance of targeted smoking cessation programs in eliminating the racial disparity in the age-related patterns of PTB rates.
目的：我们在终身邻里收入的背景下，研究了吸烟对非裔美国女性和白人女性早产（<37周）率与年龄相关模式的影响。方法：对伊利诺伊州一个包含非西班牙裔白人和非裔美国婴儿（1989 - 1991年）及其母亲（1956 - 1976年）的跨代数据集进行分层和多水平逻辑回归分析，并附加了美国人口普查收入信息。
在终身居住在低收入社区的非吸烟非裔美国女性（n = 20107）中，早产率从青少年时期的18.5%降至30 - 35岁女性的15.0%，p < 0.0001。在终身居住在低收入社区的吸烟非裔美国女性（n = 5936）中，情况则相反，p < 0.01。在向上流动的吸烟非裔美国女性（n = 756）中，早产率从青少年时期的11.1%升至30 - 35岁女性的24.9%，p < 0.05。对于终身居住在高收入社区的非裔美国女性，吸烟与早产率随年龄增长并无关联。没有任何一组白人女性，即使是终身居住在低收入社区的吸烟女性，在早产方面表现出随年龄增长而恶化的情况。结论：早产率随年龄增长而上升的这种恶化模式仅出现在早年或终身居住在低收入社区的吸烟非裔美国女性中，这凸显了针对性戒烟项目在消除早产率与年龄相关模式中的种族差异方面的公共卫生政策重要性。
