Department of Obstetrics and Gynecology, Division of General Obstetrics and Gynecology, University of South Florida, Tampa, Florida.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Am J Perinatol. 2020 Nov;37(13):1340-1350. doi: 10.1055/s-0039-1693696. Epub 2019 Jul 31.
African American women have a higher risk of spontaneous preterm birth than White and Latina women. Although Latina women are exposed to similar social determinants of health, they have lower rates of spontaneous preterm birth. One theory for this difference is the maternal stress biological pathway, whereby lifetime stressors, such as racial discrimination, lead to a premature activation of parturition. We investigated the prevalence of self-reported discrimination and its association with the prevalence of spontaneous preterm birth.
Using data from the Community Child Health Research Network Study, a multisite cohort study from 2008 to 2012, we conducted a cross-sectional analysis of 1,154 African American women and 578 Latina women.
Adjusting for multiple risk factors, African American and Latina women who experienced the highest tertile of discrimination had a higher prevalence of preterm birth compared with those who experienced discrimination less than once per year, adjusted hazard ratio (aHR) = 1.5 (0.7-3.1) and 3.6 (0.9-14.4), respectively.
In our cohort, we found a statistically significant association only in the medium discrimination group in Latina women, but we did not find a statistically significant association in African American women. Reduction in experienced discrimination may be an important intervention for reducing adverse pregnancy outcomes.
非裔美国女性比白人和拉丁裔女性更容易发生自发性早产。尽管拉丁裔女性面临着类似的健康决定因素，但她们自发性早产的发生率较低。造成这种差异的一个理论是母体应激生物学途径，即生活中的压力源，如种族歧视，会导致分娩过早激活。我们研究了自我报告的歧视的流行情况及其与自发性早产流行之间的关系。
我们利用 2008 年至 2012 年社区儿童健康研究网络研究的多地点队列研究数据，对 1154 名非裔美国女性和 578 名拉丁裔女性进行了横断面分析。
调整多种危险因素后，与每年经历歧视少于一次的女性相比，经历最高 tertile 歧视的非裔美国女性和拉丁裔女性早产的发生率更高，调整后的危险比（aHR）分别为 1.5（0.7-3.1）和 3.6（0.9-14.4）。
在我们的队列中，我们仅在拉丁裔女性的中度歧视组中发现了统计学上显著的关联，但在非裔美国女性中没有发现统计学上显著的关联。减少经历的歧视可能是减少不良妊娠结局的一个重要干预措施。
