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Created on : 03 Nov 2004
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

Racial and ethnic disparities in preterm birth: The role of stressful life events. American Journal of Obstetrics and Gynecology 2004;191(3):691-99.

Author(s) :

Lu MC, Chen B.

Year of publication :

2004

URL(s) :

http://www.sciencedirect.com/science?_ob=ArticleUR…

Résumé (français)  :

Abstract (English)  :

Objective

The purpose of this study was to examine racial-ethnic disparities in stressful life events before and during pregnancy and to assess the relationship between stressful life events and racial-ethnic disparities in preterm birth.

Study design

Using data from the Pregnancy Risk Assessment Monitoring System, we conducted a retrospective cohort analysis of a sample of 33,542 women from 19 states who were delivered of a live-born infant in 2000. Principal component analysis was used to group 13 stressful life events into 4 stress constructs: emotional, financial, partner-related, and traumatic. Racial-ethnic disparities in stressful life events were assessed with the use of bivariate and multivariate regression analyses. The contribution of stressful life events to racial-ethnic disparities in preterm birth was evaluated with the use of stepwise regression model and interaction terms.

Results

Black women and American Indian/Alaska Native women reported the highest number of stressful life events in the 12 months before delivery. Compared with non-Hispanic white women, black women were 24% more likely to report emotional stressors, 35% more likely to report financial stressors, 163% more likely to report partner-related stressors, and 83% more likely to report traumatic stressors. The addition of stress constructs to the stepwise regression model minimally affected the association between race-ethnicity and preterm birth, and none of the stress constructs were significantly associated with preterm birth. There were no significant interaction effects between race-ethnicity and stress on preterm birth, except for a modest effect between black race and traumatic stressors.

Conclusion

There are significant racial-ethnic disparities in the experience of stressful life events before and during pregnancy. Stressful life events do not appear to contribute significantly to racial-ethnic disparities in preterm birth.

Sumário (português)  :

Resumen (español)  :

Comments :

D’après le résumé, les variables envisagées ne sont pas les bonnes. D’une part ce ne sont pas les facteurs stressants qui devraient être pris en compte mais plutôt leur impact psychique sur les personnes (degré d’anxiété, de dépression, de stress post traumatique). En outre, ne considérer que les naissances prématurés d’enfants en vie ne rime pas à grand chose. Ce qu’il faudrait considérer c’est un indice global de mortalité et de morbidité des enfants et des mères.

Argument (français) :

Aux Etats-Unis, le risque de stress important avant ou pendant la grossesse dépend notablement de l’origine ethnique. Néanmoins ces stress n’augmentent pas le risque d’accouchement prématuré d’enfants viables.

Argument (English):

Argumento (português):

Argumento (español):

Keywords :

➡ depression, anxiety ; evidence-based medicine/midwifery ; premature baby ; psychology ; traumatism ; post-traumatic stress

Author of this record :

Cécile Loup — 03 Nov 2004
➡ latest update : Alison Passieux — 02 Dec 2007