The Racial Configuration of Parent Couples and Premature Birth: an Analysis of the Utah Population Database.

In this paper, we analyze detailed maternal and paternal race information in a 25-year time series of birth record data to consider racial inequities in premature births experienced by women of color and women within interracial parent couples. We analyze birth outcomes within Utah, a historically racially homogeneous state experiencing growing racial diversity and interracial marriage over the past two decades. Our analyses consider disparities in preterm birth according to maternal race and the interracial status of couples for all birth certificate records within the Utah Population Database from 1989 to 2015 (N = 1,148,818). Our results, consistent with a dyadic perspective on minority stress, indicate that maternal race and interracial parent-couple status are each significantly associated with heightened risk of premature birth. The odds of preterm birth are significantly greater among all four racialized groups in the analyses (African Americans, Asians, Native Americans, and Native Hawaiian or Pacific Islanders) as compared to White women. Furthermore, we find that mothers in mixed-race parent couples with either a white or a black father experience a greater risk of preterm birth than mothers parenting with a father of the same race. Our results suggest that in order to capture the complete perspective on racial-ethnic disparities in adverse birth outcomes, outcomes pivotal for subsequent health outcomes over the life course, it is critical to address racism's toxic effects across multiple levels of lived experience-from the individual level, to the parent dyad, to the local community and beyond.