Ethnic disparities in the risk of adverse neonatal outcome after spontaneous preterm birth

Jelle M. Schaaf, Ben Willem J Mol, Ameen Abu-Hanna, Anita C J Ravelli

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective. To describe ethnic disparities in the risk of spontaneous preterm birth and related adverse neonatal outcome. Design. Nationwide prospective cohort study. Setting. The Netherlands, 1999-2007. Population. Nine hundred and sixty-nine thousand, four hundred and ninety-one singleton pregnancies with a spontaneous onset of labor. Methods. We investigated ethnic disparities in perinatal outcome for European white, African, South-Asian, Mediterranean and East-Asian women. We performed multivariate logistic regression analyses to calculate the adjusted odds ratio (aOR) and confidence intervals (CIs) of spontaneous preterm birth and the risk of subsequent neonatal morbidity and mortality. Main outcome measures. The primary outcome measure was spontaneous preterm birth before 37 completed weeks of gestation. Secondarily, we investigated subsequent adverse neonatal outcome, which was a composite outcome of intraventricular hemorrhage, bronchopulmonary dysplasia, infant respiratory distress syndrome, neonatal sepsis or neonatal mortality within 28 days after birth. Results. Compared with European whites, the aOR of delivering preterm was 1.33 (95% CI 1.26-1.41) for African women, 1.58 (95% CI 1.47-1.69) for South-Asians, 0.88 (95% CI 0.84-0.91) for Mediterraneans and 1.04 (95% CI 0.98-1.11) for East-Asians. Subsequent odds of adverse neonatal outcome were significantly lower for African (aOR 0.51; 95% CI 0.41-0.64) and Mediterranean women (aOR 0.86; 95% CI 0.75-0.99) when compared with European whites. Conclusions. African and South-Asian women are at higher risk for preterm birth than European white women. However, the harmful effect of preterm birth on neonatal outcome is less severe for these women.

LanguageEnglish
Pages1402-1408
Number of pages7
JournalActa obstetricia et gynecologica Scandinavica
Volume91
Issue number12
DOIs
Publication statusPublished - 1 Dec 2012

Keywords

  • Ethnicity
  • neonatal morbidity
  • neonatal mortality
  • perinatal outcome
  • race
  • spontaneous preterm birth

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Schaaf, Jelle M. ; Mol, Ben Willem J ; Abu-Hanna, Ameen ; Ravelli, Anita C J. / Ethnic disparities in the risk of adverse neonatal outcome after spontaneous preterm birth. In: Acta obstetricia et gynecologica Scandinavica. 2012 ; Vol. 91, No. 12. pp. 1402-1408.
@article{4a2a23ba1aab421f8c7166aea9df109f,
title = "Ethnic disparities in the risk of adverse neonatal outcome after spontaneous preterm birth",
abstract = "Objective. To describe ethnic disparities in the risk of spontaneous preterm birth and related adverse neonatal outcome. Design. Nationwide prospective cohort study. Setting. The Netherlands, 1999-2007. Population. Nine hundred and sixty-nine thousand, four hundred and ninety-one singleton pregnancies with a spontaneous onset of labor. Methods. We investigated ethnic disparities in perinatal outcome for European white, African, South-Asian, Mediterranean and East-Asian women. We performed multivariate logistic regression analyses to calculate the adjusted odds ratio (aOR) and confidence intervals (CIs) of spontaneous preterm birth and the risk of subsequent neonatal morbidity and mortality. Main outcome measures. The primary outcome measure was spontaneous preterm birth before 37 completed weeks of gestation. Secondarily, we investigated subsequent adverse neonatal outcome, which was a composite outcome of intraventricular hemorrhage, bronchopulmonary dysplasia, infant respiratory distress syndrome, neonatal sepsis or neonatal mortality within 28 days after birth. Results. Compared with European whites, the aOR of delivering preterm was 1.33 (95{\%} CI 1.26-1.41) for African women, 1.58 (95{\%} CI 1.47-1.69) for South-Asians, 0.88 (95{\%} CI 0.84-0.91) for Mediterraneans and 1.04 (95{\%} CI 0.98-1.11) for East-Asians. Subsequent odds of adverse neonatal outcome were significantly lower for African (aOR 0.51; 95{\%} CI 0.41-0.64) and Mediterranean women (aOR 0.86; 95{\%} CI 0.75-0.99) when compared with European whites. Conclusions. African and South-Asian women are at higher risk for preterm birth than European white women. However, the harmful effect of preterm birth on neonatal outcome is less severe for these women.",
keywords = "Ethnicity, neonatal morbidity, neonatal mortality, perinatal outcome, race, spontaneous preterm birth",
author = "Schaaf, {Jelle M.} and Mol, {Ben Willem J} and Ameen Abu-Hanna and Ravelli, {Anita C J}",
year = "2012",
month = "12",
day = "1",
doi = "10.1111/aogs.12013",
language = "English",
volume = "91",
pages = "1402--1408",
journal = "Acta Obstetricia et Gynecologica Scandinavica",
issn = "0001-6349",
publisher = "Wiley-Blackwell",
number = "12",

}

Ethnic disparities in the risk of adverse neonatal outcome after spontaneous preterm birth. / Schaaf, Jelle M.; Mol, Ben Willem J; Abu-Hanna, Ameen; Ravelli, Anita C J.

In: Acta obstetricia et gynecologica Scandinavica, Vol. 91, No. 12, 01.12.2012, p. 1402-1408.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Ethnic disparities in the risk of adverse neonatal outcome after spontaneous preterm birth

AU - Schaaf, Jelle M.

AU - Mol, Ben Willem J

AU - Abu-Hanna, Ameen

AU - Ravelli, Anita C J

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Objective. To describe ethnic disparities in the risk of spontaneous preterm birth and related adverse neonatal outcome. Design. Nationwide prospective cohort study. Setting. The Netherlands, 1999-2007. Population. Nine hundred and sixty-nine thousand, four hundred and ninety-one singleton pregnancies with a spontaneous onset of labor. Methods. We investigated ethnic disparities in perinatal outcome for European white, African, South-Asian, Mediterranean and East-Asian women. We performed multivariate logistic regression analyses to calculate the adjusted odds ratio (aOR) and confidence intervals (CIs) of spontaneous preterm birth and the risk of subsequent neonatal morbidity and mortality. Main outcome measures. The primary outcome measure was spontaneous preterm birth before 37 completed weeks of gestation. Secondarily, we investigated subsequent adverse neonatal outcome, which was a composite outcome of intraventricular hemorrhage, bronchopulmonary dysplasia, infant respiratory distress syndrome, neonatal sepsis or neonatal mortality within 28 days after birth. Results. Compared with European whites, the aOR of delivering preterm was 1.33 (95% CI 1.26-1.41) for African women, 1.58 (95% CI 1.47-1.69) for South-Asians, 0.88 (95% CI 0.84-0.91) for Mediterraneans and 1.04 (95% CI 0.98-1.11) for East-Asians. Subsequent odds of adverse neonatal outcome were significantly lower for African (aOR 0.51; 95% CI 0.41-0.64) and Mediterranean women (aOR 0.86; 95% CI 0.75-0.99) when compared with European whites. Conclusions. African and South-Asian women are at higher risk for preterm birth than European white women. However, the harmful effect of preterm birth on neonatal outcome is less severe for these women.

AB - Objective. To describe ethnic disparities in the risk of spontaneous preterm birth and related adverse neonatal outcome. Design. Nationwide prospective cohort study. Setting. The Netherlands, 1999-2007. Population. Nine hundred and sixty-nine thousand, four hundred and ninety-one singleton pregnancies with a spontaneous onset of labor. Methods. We investigated ethnic disparities in perinatal outcome for European white, African, South-Asian, Mediterranean and East-Asian women. We performed multivariate logistic regression analyses to calculate the adjusted odds ratio (aOR) and confidence intervals (CIs) of spontaneous preterm birth and the risk of subsequent neonatal morbidity and mortality. Main outcome measures. The primary outcome measure was spontaneous preterm birth before 37 completed weeks of gestation. Secondarily, we investigated subsequent adverse neonatal outcome, which was a composite outcome of intraventricular hemorrhage, bronchopulmonary dysplasia, infant respiratory distress syndrome, neonatal sepsis or neonatal mortality within 28 days after birth. Results. Compared with European whites, the aOR of delivering preterm was 1.33 (95% CI 1.26-1.41) for African women, 1.58 (95% CI 1.47-1.69) for South-Asians, 0.88 (95% CI 0.84-0.91) for Mediterraneans and 1.04 (95% CI 0.98-1.11) for East-Asians. Subsequent odds of adverse neonatal outcome were significantly lower for African (aOR 0.51; 95% CI 0.41-0.64) and Mediterranean women (aOR 0.86; 95% CI 0.75-0.99) when compared with European whites. Conclusions. African and South-Asian women are at higher risk for preterm birth than European white women. However, the harmful effect of preterm birth on neonatal outcome is less severe for these women.

KW - Ethnicity

KW - neonatal morbidity

KW - neonatal mortality

KW - perinatal outcome

KW - race

KW - spontaneous preterm birth

UR - http://www.scopus.com/inward/record.url?scp=84870915533&partnerID=8YFLogxK

U2 - 10.1111/aogs.12013

DO - 10.1111/aogs.12013

M3 - Article

VL - 91

SP - 1402

EP - 1408

JO - Acta Obstetricia et Gynecologica Scandinavica

T2 - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

SN - 0001-6349

IS - 12

ER -