Neighborhood Socioeconomic Status in Relation to Preterm Birth in a U.S. Cohort of Black Women.
ABSTRACT This study examines the association between neighborhood socioeconomic status (SES) and preterm birth among U.S. Black women. A composite variable for neighborhood SES, derived from 7 U.S. Census Bureau indicators, was assessed in relation to self-reported preterm birth (505 spontaneous and 452 medically indicated) among 6,390 women in the Black Women's Health Study who delivered singleton births during 1995-2003. The odds ratio (OR) for preterm birth, comparing the lowest (most deprived) to the highest (least deprived) quartiles of neighborhood SES, was 0.98 (95 % CI, 0.80, 1.20) after adjustment for individual-level characteristics. Low neighborhood SES was not associated with spontaneous or medically indicated preterm birth overall or within strata of maternal age, education, or geographic region. The only significant finding was higher odds of medically indicated preterm birth associated with low neighborhood SES among unmarried women. Low neighborhood SES was not materially associated with preterm birth in this study of U.S. Black women.
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ABSTRACT: In order to assess racial differences in rates of idiopathic preterm labour, preterm premature rupture of membranes, and medically indicated preterm delivery, the authors analysed data on 388 preterm (< 37 completed weeks of gestation) births (7.9% of all births) occurring between 1 September 1988 and 31 August 1989, in three central North Carolina counties. The crude relative risk (RR) of preterm birth among black women compared with white women was 2.6 [95% confidence interval (CI) 2.1, 3.1]. With adjustment for age, gravidity, marital status, education, and county of residence, the estimated relative risk for black women compared with white women was 2.1 (95% CI 1.1, 4.1) for medically indicated preterm delivery, 1.6 (95% CI 1.1, 2.3) for preterm birth as a result of preterm labour, and 1.9 (95% CI 1.2, 3.1) for preterm premature rupture of membranes. Compared with white women, black women were at the highest risk of a preterm birth before 34 weeks of gestation (RR = 2.9; 95% CI 1.8, 4.7). The risk of medically indicated preterm delivery at 36 weeks was considerably higher for black women than for white women (RR = 3.4; 95% CI 1.1, 10.2). For a better understanding and ultimately a reduction of the risk for preterm delivery among black women, investigation of specific aetiological pathways and gestational age groups may be required.Paediatric and Perinatal Epidemiology 07/1995; 9(3):281-95. DOI:10.1111/j.1365-3016.1995.tb00144.x · 2.81 Impact Factor
- Journal of the American Medical Women's Association (1972) 11/1994; 50(2):56-8.
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ABSTRACT: This paper provides an overview of problems in multivariate modeling of epidemiologic data, and examines some proposed solutions. Special attention is given to the task of model selection, which involves selection of the model form, selection of the variables to enter the model, and selection of the form of these variables in the model. Several conclusions are drawn, among them: a) model and variable forms should be selected based on regression diagnostic procedures, in addition to goodness-of-fit tests; b) variable-selection algorithms in current packaged programs, such as conventional stepwise regression, can easily lead to invalid estimates and tests of effect; and c) variable selection is better approached by direct estimation of the degree of confounding produced by each variable than by significance-testing algorithms. As a general rule, before using a model to estimate effects, one should evaluate the assumptions implied by the model against both the data and prior information.American Journal of Public Health 04/1989; 79(3):340-9. DOI:10.2105/AJPH.79.3.340 · 4.23 Impact Factor