The Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland.
Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
Am J Prev Med. 2022 Jun;62(6):885-894. doi: 10.1016/j.amepre.2021.12.027. Epub 2022 Apr 7.
Having a preterm birth is associated with future cardiovascular risk. Non-Hispanic Black women have higher rates of preterm birth than non-Hispanic White and Hispanic women, but nativity-related disparities in preterm birth are not well understood.
Data from 6,096 women in the Boston Birth Cohort: non-Hispanic Black (2,699), non-Hispanic White (997), or Hispanic (2,400), were analyzed in June 2021. Differences in cardiovascular risk factors were assessed. The association of preterm birth with nativity and duration of U.S. residence were investigated using multivariable logistic regression.
U.S.-born women in all 3 racial-ethnic groups had a higher prevalence of obesity, smoking, and severe stress than foreign-born women. Foreign-born non-Hispanic Black and Hispanic women had lower odds of preterm birth than U.S.-born counterparts (non-Hispanic Black: AOR=0.79, 95% CI=0.65, 0.97; Hispanic: AOR=0.72, 95% CI=0.56, 0.93). In all the 3 groups, foreign-born women with shorter (<10 years) duration of U.S. residence had lower odds of preterm birth than the U.S.-born women (non-Hispanic Black: AOR=0.57, 95% CI=0.43, 0.75; Hispanic: AOR=0.72, 95% CI=0.55, 0.94; non-Hispanic White: AOR=0.46, 95% CI=0.25, 0.85), whereas the odds of preterm birth in foreign-born women with ≥10 years of residence were not significantly different.
Foreign-born women had better cardiovascular risk profiles in all groups and lower odds of preterm birth in non-Hispanic Black and Hispanic groups. In all the 3 groups, a shorter duration of U.S. residence was associated with lower odds of preterm birth. Further studies are needed to understand the biological and social determinants underlying these nativity-related disparities and the impact of acculturation.
早产与未来的心血管风险相关。非西班牙裔黑种女性的早产率高于非西班牙裔白种人和西班牙裔女性，但与出生有关的早产差异尚不清楚。
2021 年 6 月分析了 6096 名波士顿出生队列中的女性的数据：非西班牙裔黑人（2699 名）、非西班牙裔白人（997 名）或西班牙裔（2400 名）。评估了心血管危险因素的差异。使用多变量逻辑回归调查了早产与出生国和在美国居住时间的关系。
所有 3 个种族群体中的美国出生女性的肥胖、吸烟和严重压力的患病率均高于外国出生女性。与美国出生的同龄人相比，外国出生的非西班牙裔黑人和西班牙裔女性的早产率较低（非西班牙裔黑人：AOR=0.79，95%CI=0.65，0.97；西班牙裔：AOR=0.72，95%CI=0.56，0.93）。在所有 3 个群体中，在美国居住时间较短（<10 年）的外国出生女性的早产率低于美国出生的女性（非西班牙裔黑人：AOR=0.57，95%CI=0.43，0.75；西班牙裔：AOR=0.72，95%CI=0.55，0.94；非西班牙裔白人：AOR=0.46，95%CI=0.25，0.85），而在美国居住时间≥10 年的外国出生女性的早产率则无显著差异。
在所有组中，外国出生的女性具有更好的心血管风险特征，而非西班牙裔黑人和西班牙裔女性的早产率较低。在所有 3 个群体中，在美国居住时间较短与早产率较低有关。需要进一步研究以了解这些与出生有关的差异背后的生物学和社会决定因素以及文化适应的影响。
