Very Low Birthweight in African American Infants: The Role of Maternal Exposure to Interpersonal Racial Discrimination
James W. Collins, Jr, MD, MPH,
Richard J. David, MD,
Arden Handler, DrPH,
Stephen Wall, MD and
Steven Andes, PhD
James W. Collins Jr is with the Department of Pediatrics, Childrens Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, Ill. Richard J. David is with the Department of Pediatrics, Cook County ospital, University of Illinois Medical School, Chicago. Arden Handler and Steven Andes are with the School of Public Health, University of Illinois, Chicago. At the time of the study, Stephen Wall was with the University of Chicago Hospital, Chicago, Ill.
Correspondence: Requests for reprints should be sent to James W. Collins Jr, Division of Neonatology, Childrens Memorial Hospital, 2300 Childrens Plaza, No. 45, Chicago, IL 60614 (e-mail: jcollins{at}northwestern.edu).
Objectives. We determined whether African American womenslifetime exposure to interpersonal racial discrimination isassociated with pregnancy outcomes.
Methods. We performed a casecontrol study among 104 AfricanAmerican women who delivered very low birthweight (<1500g) preterm (<37 weeks) infants and 208 African American womenwho delivered nonlow-birthweight (>2500g) term infantsin Chicago, Ill.
Results. The unadjusted and adjusted odds ratio of very lowbirthweight infants for maternal lifetime exposure to interpersonalracism in 3 or more domains equaled 3.2 (95% confidence intervals=1.5,6.6) and 2.6 (1.2, 5.3), respectively. This association tendedto persist across maternal sociodemographic, biomedical, andbehavioral characteristics.
Conclusions. The lifelong accumulated experiences of racialdiscrimination by African American women constitute an independentrisk factor for preterm delivery.
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