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Am J Perinatol 2013; 30(06): 433-450
DOI: 10.1055/s-0032-1326988
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Ethnic and Racial Disparities in the Risk of Preterm Birth: A Systematic Review and Meta-Analysis

Jelle M. Schaaf
1   Department of Medical Informatics, Academic Medical Centre, Amsterdam, The Netherlands
2   Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands
,
Sophie M.S. Liem
2   Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands
3   Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
,
Ben Willem J. Mol
2   Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands
,
Ameen Abu-Hanna
1   Department of Medical Informatics, Academic Medical Centre, Amsterdam, The Netherlands
,
Anita C.J. Ravelli
1   Department of Medical Informatics, Academic Medical Centre, Amsterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

06 February 2012

24 May 2012

Publication Date:
11 October 2012 (online)

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Abstract

Objectives The aim of this study is to present a systematic review of available literature on the effect of maternal ethnicity (Africans/blacks, Asians, Hispanics, others) on the risk of preterm birth (PTB).

Study Design Studies investigating ethnicity (or race) as a risk factor for PTB were included if performing adjustments for confounders. A meta-analysis was performed, and data were synthesized using a random effects model.

Results Forty-five studies met the inclusion criteria. Black ethnicity was associated with an increased risk of PTB when compared with whites (range of adjusted odds ratios [ORs] 0.6 to 2.8, pooled OR 2.0; 95% confidence interval [CI] 1.8 to 2.2). For Asian ethnicity, there was no significant association (range of adjusted ORs 0.6 to 2.3). For Hispanic ethnicity, there also was no significant association (range of adjusted ORs 0.7 to 1.5).

Conclusions Ethnic disparities in the risk of PTB were clearly pronounced among black women. Future research should focus on preventative strategies for ethnic groups at high risk for PTB. Information on ethnic disparities in risk of PTB-related neonatal morbidity and mortality is lacking and is also a topic of interest for future research.

Keywords

preterm birth - race - ethnicity - systematic review - meta-analysis - perinatal mortality - risk factors
 

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