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Racial Disparities in Biopsychosocial Factors and Spontaneous Preterm Birth Among Rural Low-Income Women

Authors

  • D. Elizabeth Jesse CNM, PhD,

    Corresponding author
      D. Elizabeth Jesse, CNM, PhD, East Carolina University, College of Nursing, 3160 Health Science Building, Greenville, NC 27858. E-mail: jessed@ecu.edu
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    • D. Elizabeth Jesse, CNM, PhD, is an associate professor at the East Carolina University College of Medicine, Greenville, NC.

  • Melvin S. Swanson PhD,

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    • Melvin S. Swanson, PhD, is a professor of statistics in the Research Department of East Carolina University School of Nursing, Greenville, NC.

  • Edward R. Newton MD,

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    • Edward R. Newton, MD, is professor and chairman of the Department of Obstetrics and Gynecology at East Carolina University Brody School of Medicine, chief of Ob/Gyn Service Pitt County Memorial Hospital, and director of Nurse-Midwifery Services at Pitt County Health Department, Greenville, NC.

  • John Morrow MD

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    • John Morrow, MD, is director of the Pitt County Health Department, Greenville, NC.


D. Elizabeth Jesse, CNM, PhD, East Carolina University, College of Nursing, 3160 Health Science Building, Greenville, NC 27858. E-mail: jessed@ecu.edu

ABSTRACT

In this descriptive prospective study, 269 African American, Hispanic, and Caucasian women from rural prenatal clinics were interviewed once between 16 and 28 weeks'gestation. Associations between biopsychosocial risk factors and preterm birth (PTB) were examined. African American women with spontaneous PTB were more likely to be older, and to have higher Bowman Gray Risk Index scores and hypertensive diseases of pregnancy than African American women who did not have a spontaneous PTB. There were significant differences in bacterial vaginosis, hypertensive diseases of pregnancy, smoking, social support from others, and self-esteem among the three racial groups. In the total sample after adjustment for sociodemographic and biopsychosocial factors, women with spontaneous PTB were three times more likely to be African American, to have oligohydramnios, hypertensive diseases of pregnancy, and had higher Bowman Gray Risk Index scores than the total sample of women without spontaneous PTB. Understanding the risks associated with spontaneous PTBs that are unique to African American women and why biopsychosocial risk factors vary by racial/ethnic group may lead to tailored interventions.

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