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Risks of preterm birth among non-Hispanic black and non-Hispanic white women: Effect modification by maternal age.

ABSTRACT: BACKGROUND:Preterm birth (PTB) disproportionately affects African American compared with Caucasian women, although reasons for this disparity remain unclear. Some suggest that a differential effect of maternal age by race/ethnicity, especially at older maternal ages, may explain disparities. OBJECTIVE:To determine whether the relationship between maternal age and preterm birth varies by race/ethnicity among primiparae non-Hispanic blacks (NHB) and non-Hispanic whites (NHW). METHODS:A cross-sectional study of 367 081 singleton liveborn first births to NHB and NHW women in California from 2008 to 2012 was conducted. Rate ratios (RR) were estimated for PTB and its subtypes-spontaneous and clinician-initiated-after adjusting for confounders through Poisson regression. Universal age/race reference groups (NHW, 25-29 years) and race-specific reference groups (NHW or NHB, 25-29 years) were used for comparisons. RESULTS:Among all women, RR of PTB was highest at the extremes of age (<15 and ?40 years). Among NHBs, the risk of PTB was higher than among NHWs at all maternal ages (adjusted RR of PTB 1.38-2.93 vs 0.98-2.38). However, using race-specific reference groups, the risk of PTB for NHB women (RR 0.91-1.88) vs NHW women (RR 0.98-2.39) was nearly identical at all maternal ages, with overlapping confidence intervals. Analyses did not demonstrate substantial divergence of risk with advancing maternal age. PTB, spontaneous PTB, and clinician-initiated PTB demonstrated similar risk patterns at younger but not older maternal ages, where risk of clinician-initiated PTB increased sharply for all women. CONCLUSIONS:Primiparae NHBs demonstrated increased risk of PTB, spontaneous PTB, and clinician-initiated PTB compared with NHWs at all maternal ages. However, RRs using race-specific reference groups converged across maternal ages, indicating a similar independent effect of maternal age on PTB by race/ethnicity. A differential effect of maternal age does not appear to explain disparities in preterm birth by race/ethnicity.

SUBMITTER: Keiser AM

PROVIDER: S-EPMC6993282 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Risks of preterm birth among non-Hispanic black and non-Hispanic white women: Effect modification by maternal age.

Keiser Amaris M AM Salinas Yasmmyn D YD DeWan Andrew T AT Hawley Nicola L NL Donohue Pamela K PK Strobino Donna M DM

Paediatric and perinatal epidemiology 20190731 5

<h4>Background</h4>Preterm birth (PTB) disproportionately affects African American compared with Caucasian women, although reasons for this disparity remain unclear. Some suggest that a differential effect of maternal age by race/ethnicity, especially at older maternal ages, may explain disparities.<h4>Objective</h4>To determine whether the relationship between maternal age and preterm birth varies by race/ethnicity among primiparae non-Hispanic blacks (NHB) and non-Hispanic whites (NHW).<h4>Met ...[more]

PMID: 31365156

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Project description:OBJECTIVE:Research suggests a difference in sweet taste perception between non-Hispanic black (NHB) and non-Hispanic white (NHW) adults; however, limited research has examined sweet taste perception in relation to the dietary intake of sweet products. The aim of this study was to examine sweet taste perception and the consumption of sweet foods, beverages, and sugar in NHB and NHW adults, and to evaluate whether sweet taste perception is associated with dietary intake. METHODS:This cross-sectional study examined the association between race, sweet taste perception and sweet food, beverages, and sugar consumption in healthy, NHB and NHW adults. Seven day food records were analyzed in Nutrition Data System for Research software. Intensity of sweet taste perception was tested and the general labeled magnitude scale method was used to facilitate group comparisons. Independent t tests, Mann-Whitney tests, and Pearson correlations were used to assess associations. RESULTS:Participants were NHB (n?=?98) and NHW (n?=?90) adults, 41 ± 1 y of age (mean ± SEM) with energy intake of 2271 ± 53 kcal. Body mass index was higher in NHBs than in NHWs (36 ± 1 versus 32 ± 1 kg/m2, P?=?0.048), but no differences were observed in age, energy consumption, or total sugar intake. Sweet taste perception rating (median [interquartile range] NHB: 73.5 [63.9-83], NHW: 52.1 [46.4-57.7]; P?=?0.001) and added sugar intake (NHB: 39.4 g/1000 kcal [36.3-42.4], NHW: 30 g/1000 kcal [26.7-33.4]; P < 0.001) were greater in NHB. Perceived sweet taste intensity was positively associated with consumption of servings of sweet products among NHBs (R2?=?0.057, P?=?0.018) but not NHWs (R2?=?-0.012, P?=?0.314). CONCLUSIONS:NHBs have a higher intensity of sweet taste perception than NHWs. The positive association of sweet taste perception and sweet product consumption in NHBs suggests that a higher intensity of sweet taste perception may be associated with an increased proportion of energy consumption from added sugars.

Project description:A dietary assessment instrument designed for use in a nationally representative pediatric population was required to examine associations between calcium intake and bone mineral accrual in a large, multicenter study.To determine the reproducibility and intermethod reliability of a youth calcium food frequency questionnaire (FFQ) in a multiracial/ethnic sample of children and adolescents.Reproducibility (n=69) and intermethod reliability (n=393) studies were conducted by administering repeat FFQs and three unannounced 24-hour dietary recalls to stratified random samples of individuals participating in the Bone Mineral Density in Childhood Study.Children and adolescents ages 5 to 21 years.Calcium intake estimated from the FFQ and 24-hour dietary recalls.Reproducibility was assessed by the intraclass correlation coefficient (ICC). Intermethod reliability was assessed by deattenuated Pearson correlations between the FFQ and 24-hour recalls. Attenuation factors and calibration corrected effect estimates for bone density were calculated to determine the potential influence of measurement error on associations with health outcomes.The ICC (0.61) for repeat administrations and deattenuated Pearson correlation between the FFQ and 24-hour recalls (r=0.60) for all subjects indicated reproducibility and intermethod reliability (Pearson r=0.50 to 0.74 across sex and age groups). Attenuation factors were ?0.50 for all sex and age groups and lower for non-Hispanic blacks (?=0.20) and Hispanics (?=0.26) than for non-Hispanic whites (?=0.42).The Bone Mineral Density in Childhood Study calcium FFQ appears to provide a useful tool for assessing calcium intake in children and adolescents drawn from multiracial/ethnic populations and/or spanning a wide age range. However, similar to other FFQs, attenuation factors were substantially <1, indicating the potential for appreciable measurement error bias. Calibration correction should be performed and racial/ethnic differences in performance considered when analyzing and interpreting findings based on this instrument.

Dataset Information

Risks of preterm birth among non-Hispanic black and non-Hispanic white women: Effect modification by maternal age.

Publications

Risks of preterm birth among non-Hispanic black and non-Hispanic white women: Effect modification by maternal age.

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