Minority Health Archive

What causes racial disparities in very preterm birth? A biosocial perspective.

Kramer, Michael R and Hogue, Carol R (2009) What causes racial disparities in very preterm birth? A biosocial perspective. Epidemiologic reviews, 31. pp. 84-98. ISSN 1478-6729

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Very preterm birth (<32 weeks' gestation) occurs in approximately 2% of livebirths but is a leading cause of infant mortality and morbidity in the United States. African-American women have a 2-fold to 3-fold elevated risk compared with non-Hispanic white women for reasons that are incompletely understood. This paper reviews the evidence for the biologic and social patterning of very preterm birth, with attention to leading hypotheses regarding the etiology of the racial disparity. A systematic review of the literature in the MEDLINE, CINAHL, PsycInfo, and EMBASE indices was conducted. The literature to date suggests a complex, multifactorial causal framework for understanding racial disparities in very preterm birth, with maternal inflammatory, vascular, or neuroendocrine dysfunction as proximal pathways and maternal exposure to stress, racial differences in preconceptional health, and genetic, epigenetic, and gene-environment interactions as more distal mediators. Interpersonal and institutionalized racism are mechanisms that may drive racially patterned differences. Current literature is limited in that research on social determinants and biologic processes of prematurity has been generally disconnected. Improved etiologic understanding and the potential for effective intervention may come with better integration of these research approaches.

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Item Type: Article
Additional Information: This article is available at the publisher’s Web site. Access to the full text is subject to the publisher’s access restrictions.
Uncontrolled Keywords: continental population groups, health status disparities, pregnancy complications, infectious, premature birth
Subjects: Health > Disparities
Health > Prenatal & Pediatric Health
Practice > interventions
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Depositing User: Users 141 not found.
Date Deposited: 26 Jul 2011 13:14
Last Modified: 26 Jul 2011 13:14
Link to this item (URI): http://health-equity.lib.umd.edu/id/eprint/2869

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