Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; CHOP PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA; Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA.
J Pediatr. 2022 Jan;240:24-30.e2. doi: 10.1016/j.jpeds.2021.09.035. Epub 2021 Sep 28.
To explore the relative risks of preterm birth-both overall and stratified into 3 groups (late, moderate, and extreme prematurity)-associated with maternal race, ethnicity, and nativity (ie, birthplace) combined.
This was a retrospective cross-sectional cohort study of women delivering a live birth in Pennsylvania from 2011 to 2014 (n = 4 499 259). Log binomial and multinomial regression analyses determined the relative risks of each strata of preterm birth by racial/ethnic/native category, after adjusting for maternal sociodemographic, medical comorbidities, and birth year.
Foreign-born women overall had lower relative risks of both overall preterm birth and each strata of prematurity when examined en bloc. However, when considering maternal race, ethnicity, and nativity together, the relative risk of preterm birth for women in different racial/ethnic/nativity groups varied by preterm strata and by race. Being foreign-born appeared protective for late prematurity. However, only foreign-born White women had lower adjusted relative risks of moderate and extreme preterm birth compared with reference groups. All ethnic/native sub-groups of Black women had a significantly increased risk of extreme preterm births compared with US born non-Hispanic White women.
Race, ethnicity, and nativity contribute differently to varying levels of prematurity. Future research involving birth outcome disparities may benefit by taking a more granular approach to the outcome of preterm birth and considering how nativity interacts with race and ethnicity.
综合探讨母亲的种族、民族和出生地（即出生地点）与早产之间的关系，包括整体早产风险和分为三组（晚期、中期和极早产）的早产风险。
这是一项回顾性的横断面队列研究，对 2011 年至 2014 年在宾夕法尼亚州分娩活产儿的女性（n=4499259 人）进行了研究。在调整了产妇社会人口统计学、合并症和出生年份等因素后，使用对数二项式和多项逻辑回归分析确定了按种族/民族/出生地类别分层的每个早产组的相对风险。
总体而言，与整体早产和各层早产相比，外国出生的女性的相对风险较低。然而，当同时考虑母亲的种族、民族和出生地时，不同种族/民族/出生地群体的早产相对风险因早产分层和种族而异。与参考组相比，外国出生的女性似乎对晚期早产有保护作用。然而，只有外国出生的白人女性与其他种族/民族相比，其中度和极早产的调整后相对风险较低。与美国出生的非西班牙裔白人女性相比，所有黑人女性的种族/民族亚组都有极高早产的风险显著增加。
种族、民族和出生地对不同程度的早产有不同的影响。未来涉及出生结局差异的研究可能会受益于采用更细致的方法来研究早产结局，并考虑出生地与种族和民族之间的相互作用。
