Sudhinaraset May, Vilda Dovile, Gipson Jessica D, Bornstein Marta, Wallace Maeve E
Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California.
Mary Amelia Douglas-Whited Community Women's Health Education Center, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
Am J Prev Med. 2020 Dec;59(6):787-795. doi: 10.1016/j.amepre.2020.07.025. Epub 2020 Oct 13.
Reproductive rights policies can potentially support or inhibit individuals' abilities to attain the highest standard of reproductive and sexual health; however, research is limited on how broader social policies may differentially impact women of color and immigrants in the U.S. This study examines the associations among state-level reproductive rights policies, race, and nativity status with preterm birth and low birth weight in the U.S.
This was a retrospective, cross-sectional analysis of all births occurring within all the 50 states and the District of Columbia using vital statistics birth record data in 2016 (N=3,945,875). Modified log-Poisson regression models with generalized estimating equations were fitted to estimate the RR of preterm birth and low birth weight associated with tertiles of the reproductive rights policies index. Analyses were conducted between 2019 and 2020.
Compared with women in states with the most restrictive reproductive rights policies, women living in the least restrictive states had a 7% lower low birth weight risk (adjusted RR=0.93, 95% CI=0.88, 0.99). In particular, low birth weight risk was 8% lower among Black women living in the least restrictive states than among their counterparts living in the most restrictive states (adjusted RR=0.92, 95% CI=0.86, 0.99). In addition, low birth weight risk was 6% lower among U.S.-born Black women living in the least restrictive states than among those living in the most restrictive states, but this was marginally significant (adjusted RR=0.94, 95% CI=0.89, 1.00). No other significant associations were found for race-nativity-stratified models.
Women living in states with fewer restrictions related to reproductive rights have lower rates of low birth weight, especially for Black women.
生殖权利政策可能会促进或抑制个人达到最高标准的生殖与性健康的能力；然而，关于更广泛的社会政策如何对美国有色人种女性和移民产生不同影响的研究却很有限。本研究考察了美国州级生殖权利政策、种族和出生地状况与早产和低出生体重之间的关联。
这是一项回顾性横断面分析，利用2016年生命统计出生记录数据，对美国50个州和哥伦比亚特区内所有出生情况进行分析（N = 3,945,875）。采用带有广义估计方程的修正对数泊松回归模型，以估计与生殖权利政策指数三分位数相关的早产和低出生体重的风险比。分析于2019年至2020年进行。
与生殖权利政策限制最严格的州的女性相比，生活在限制最宽松的州的女性低出生体重风险低7%（调整后风险比 = 0.93，95%置信区间 = 0.88, 0.99）。特别是，生活在限制最宽松的州的黑人女性的低出生体重风险比生活在限制最严格的州的同行低8%（调整后风险比 = 0.92，95%置信区间 = 0.86, 0.99）。此外，生活在限制最宽松的州的美国出生的黑人女性的低出生体重风险比生活在限制最严格的州的女性低6%，但这一差异仅具有边际显著性（调整后风险比 = 0.94，95%置信区间 = 0.89, 1.00）。在种族 - 出生地分层模型中未发现其他显著关联。
生活在生殖权利限制较少的州的女性低出生体重发生率较低，尤其是黑人女性。
