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Am J Perinatol 2019; 36(04): 383-392
DOI: 10.1055/s-0038-1668554
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Cross-Generational Contributors to Preterm Birth in California: Singletons Based on Race/Ethnicity

Lissa N. Francois
1   Maternal Fetal Medicine Center, Valley Children's Healthcare, Madera, California
,
Juan Yang
2   Genetic Disease Screening Program, California Department of Public Health, Richmond, California
,
Rebecca J. Baer
3   Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, California
4   California Preterm Birth Initiative, University of California, San Francisco, California
,
Paul J. Chung
5   Department of Pediatrics, University of California, Los Angeles School of Medicine, Los Angeles, California
,
Laura L. Jelliffe-Pawlowski
4   California Preterm Birth Initiative, University of California, San Francisco, California
6   Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California
,
Tumaini R. Coker
7   Department of Pediatrics, University of Washington, Seattle, Washington
8   Seattle Children's Research Institute, Seattle, Washington
› Author Affiliations Funding This research was supported by funding from the California Preterm Birth Initiative within the University of California, San Francisco.
Further Information

Publication History

17 January 2018

11 July 2018

Publication Date:
19 August 2018 (online)

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Abstract

Objective Multiple studies have examined cross-generational patterns of preterm birth (PTB), yet results have been inconsistent and generally focused on primarily white populations. We examine the cross-generational PTB risk across racial/ethnic groups.

Study Design Retrospective study of 388,474 grandmother–mother–infant triads with infants drawn from birth registry of singleton live births between 2005 and 2011 in California. Using logistic regression (odds ratios [ORs] and confidence intervals [CIs]), we examined the risk of preterm delivery by gestational age, sociodemographic, socioeconomic, and obstetric clinical characteristics stratified by maternal race/ethnicity.

Results The risk of having a preterm infant <32 weeks was greater for women born at <32 weeks (OR: 2.09, 95% CI: 1.62–2.70) and 32 to 36 weeks (OR: 1.51, 95% CI: 1.35–1.70). This increased risk of preterm delivery was present among women in all race/ethnicity groups (white [AOR: 2.00, 95% CI: 1.52–2.63), black [AOR: 1.79, 95% CI: 1.37–2.34], Hispanic [AOR: 2.39, 95% CI: 2.05–2.79], and Asian [AOR: 2.12, 95% CI: 1.20–3.91]), with hypertension as the only consistent risk factor associated with increased risk of preterm delivery.

Conclusion Our findings suggest a cross-generational risk of PTB that is consistent across race/ethnicity with hypertension as the only consistent risk factor.

Keywords

birth - outcome - gestational age - preterm birth