National Center for PTSD, Women's Health Sciences Division at VA Boston Healthcare System, Boston, MA, USA.
Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
J Womens Health (Larchmt). 2024 Jul;33(7):863-869. doi: 10.1089/jwh.2023.0162. Epub 2024 Apr 19.
Non-Hispanic Black women have increased rates of preterm birth and low infant birth weight. However, we do not know if these disparities replicate in women veterans, a population that may be at further risk for poor perinatal outcomes. This study sought to examine ethnoracial differences in preterm birth and low infant birth weight in veterans. A national sample of randomly chosen women veterans (i.e., oversampled for residency in high crime neighborhoods) reported information about all pregnancies they have had in their life, demographic characteristics, and history of childhood trauma exposures. The analytic sample was limited to individuals who identified as Hispanic/Latinx, Black, or White ( = 972). Mixed-effects regression models were used to examine ethnoracial differences in gestational age at delivery and infant birth weight, controlling for age at pregnancy, childhood trauma exposure, pregnancy during military service, income, and education. Both Black and Hispanic/Latinx veterans were significantly more likely to have an infant born at lower gestational age ( = -1.04 and = -1.11, respectively) and lower infant birth weight ( = -195.83 and = -144.27, respectively) as compared with White veterans in covariate-adjusted models. Black (odds ratio = 3.24, confidence interval = 1.16, 9.09) veterans were more likely to meet the clinical definition of preterm birth as compared with White veterans. Results align with what is seen in the general population regarding ethnoracial disparities in gestational age at delivery and infant birth weight. Findings highlight the critical need for more research on mechanisms and prevention efforts for ethnoracial disparities in perinatal outcomes.
非西班牙裔黑人女性的早产率和低出生体重婴儿比例较高。然而,我们尚不清楚这些差异是否会在女性退伍军人中重现,因为这群人可能面临更差的围产期结局风险。本研究旨在探讨退伍军人中种族差异对早产和低出生体重的影响。
一项针对随机选择的女性退伍军人的全国性样本(即根据居住在高犯罪率社区的情况进行了超额抽样)报告了她们一生中所有妊娠的信息、人口特征和儿童期创伤暴露史。分析样本仅限于自认为是西班牙裔/拉丁裔、黑人或白人的个体(=972)。采用混合效应回归模型,控制妊娠年龄、儿童期创伤暴露、军旅期间妊娠、收入和教育等因素,检验分娩时的孕龄和婴儿出生体重方面的种族差异。
与白人退伍军人相比,黑人(= -1.04)和西班牙裔/拉丁裔(= -1.11)退伍军人的婴儿出生时的孕龄明显更低,婴儿出生体重也更低(= -195.83 和= -144.27),在经过协变量调整的模型中。与白人退伍军人相比,黑人(比值比=3.24,置信区间=1.16,9.09)退伍军人更有可能符合早产的临床定义。
研究结果与一般人群中关于分娩时孕龄和婴儿出生体重的种族差异一致。这些发现突显了需要更多研究来探讨围产期结局中种族差异的机制和预防措施。