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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.151589v1 99/10/1864    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Holzman, C. Articles by Elo, I. T. PubMed PubMed Citation Articles by Holzman, C. Articles by Elo, I. T. Related Collections Geography Birth Outcomes African Americans/Blacks Socioeconomic Factors Other Tobacco Women's Health

Claudia Holzman, DVM, PhD, MPH, Janet Eyster, PhD, Mary Kleyn, MS, Lynne C. Messer, PhD, Jay S. Kaufman, PhD, Barbara A. Laraia, RD, PhD, MPH, Patricia O'Campo, PhD, Jessica G. Burke, PhD, MHS, Jennifer Culhane, PhD, MPH and Irma T. Elo, PhD, MPA

Claudia Holzman and Janet Eyster are with the Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing. Mary Kleyn is with the Michigan Department of Community Health, Lansing. Lynne C. Messer is with the Center for Health Policy, Duke University, Durham, NC. Jay S. Kaufman is with the Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec. Barbara A. Laraia is with the Center for Health and Community, Division of Prevention Services, Department of Medicine, University of California-San Francisco, CA. Patricia O'Campo is with the divisions of Epidemiology and Social and Behavioural Sciences, Dalla Lana School of Public Health, University of Toronto, Ontario. Jessica G. Burke is with the Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, PA. Jennifer Culhane is with the Department of Obstetrics and Gynecology, College of Medicine, Drexel University, Philadelphia, PA. Irma T. Elo is with the Department of Sociology and the Population Studies Center, University of Pennsylvania, Philadelphia.

Correspondence: Correspondence should be sent to Claudia Holzman, Department of Epidemiology, College of Human Medicine, Michigan State University, B601 West Fee Hall, East Lansing, MI 48824 (e-mail: cholzman{at}epi.msu.edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We compared the association between advancing maternal age and risk of preterm delivery across 4 groups (Black smokers, Black nonsmokers, White smokers, White nonsmokers) and within the context of neighborhood deprivation levels.

Methods. We obtained data from linked census and birth records for singletons (n = 182 938) delivered by women aged 20 to 39 years in Philadelphia, Pennsylvania; Baltimore, Maryland; 16 Michigan cities; 3 Maryland counties; and 2 North Carolina counties. Results from area-specific multilevel logistic regression models were combined to obtain pooled estimates of relations between maternal age and risk of preterm delivery. We repeated the models after categorizing women by neighborhood deprivation level (low, medium, and high).

Results. Among multiparous women, there was a significant age-related increase in preterm delivery in 3 of the 4 groups. The adjusted odds ratio per 5-year age increase was 1.31 in Black smokers, 1.11 in Black nonsmokers, and 1.16 in White smokers. In each group, the odds ratio increased as neighborhood deprivation increased.

Conclusions. These results support the "weathering" hypothesis, suggesting that Black women, women with high-risk behaviors, and women living in high-deprivation neighborhoods may develop "accelerated aging" that increases preterm delivery risk.