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© 2004 American Public Health Association
RESEARCH AND PRACTICE |
Sarah Mustillo is with the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC. Nancy Krieger is with the Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Mass. Erica P. Gunderson and Stephen Sidney are with the Division of Research, Kaiser Permanente Medical Care Program, Oakland, Calif. At the time of the study, Heather McCreath was with the Division of Preventive Medicine, University of Alabama at Birmingham. Catarina I. Kiefe is with the Division of Preventive Medicine, University of Alabama at Birmingham, and the Birmingham Veterans Affairs Medical Center.
Correspondence: Requests for reprints should be sent to Sarah Mustillo, PhD, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 3454, Durham, NC 27710 (e-mail:smustillo{at}psych.duhs.duke.edu).
Objectives. We examined the effects of self-reported experiences of racial discrimination on Black–White differences in preterm (less than 37 weeks gestation) and low-birthweight (less than 2500 g) deliveries.
Methods. Using logistic regression models, we analyzed data on 352 births among women enrolled in the Coronary Artery Risk Development in Young Adults Study.
Results. Among Black women, 50% of those with preterm deliveries and 61% of those with low-birthweight infants reported having experienced racial discrimination in at least 3 situations; among White women, the corresponding percentages were 5% and 0%. The unadjusted odds ratio for preterm delivery among Black versus White women was 2.54 (95% confidence interval [CI]=1.33, 4.85), but this value decreased to 1.88 (95% CI=0.85, 4.12) after adjustment for experiences of racial discrimination and to 1.11 (95% CI=0.51, 2.41) after additional adjustment for alcohol and tobacco use, depression, education, and income. The corresponding odds ratios for low birthweight were 4.24 (95% CI=1.31, 13.67), 2.11 (95% CI=0.75, 5.93), and 2.43 (95% CI=0.79, 7.42).
Conclusions. Self-reported experiences of racial discrimination were associated with preterm and low-birthweight deliveries, and such experiences may contribute to Black–White disparities in perinatal outcomes.
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