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Updated: Apr 25, 2026
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Preterm birth and subsequent risk of type 2 diabetes in black women
Tamarra James-Todd1, Lauren Wise, Deborah Boggs
1From the aDepartment of Medicine, Division of Women's Health, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; bSlone Epidemiology Center at Boston University, Boston, MA; and cDepartment of Epidemiology, Harvard School of Public Health, Boston, MA.
Background:
Gestational diabetes is a precursor to type 2 diabetes. Little is known about the relation of other common pregnancy complications, such as preterm birth, to risk of type 2 diabetes.
Methods:
We assessed preterm birth in relation to incident type 2 diabetes among 31,101 participants from the Black Women's Health Study. Preterm birth, defined as <37 weeks gestation, was reported at baseline (1995) and on subsequent biennial follow-up questionnaires. Self-reported type 2 diabetes diagnoses were ascertained on biennial questionnaires through 2009. We used Cox proportional hazards models to calculate incidence rate ratios (IRRs) and 95% confidence intervals (CIs), adjusting for potential confounders.
Results:
At baseline, 5162 participants (19%) reported a history of giving birth preterm, of which 16% occurred at <32 weeks gestation. A total of 3261 cases of type 2 diabetes were ascertained during follow-up. Ever having had a preterm birth was associated with a 20% increased risk (95% CI = 1.11-1.31) after adjusting for age at first birth, family history of diabetes, education, respondent having been born preterm, and body mass index. Gestational age <32 weeks was associated with the greatest risk (IRR = 1.27 [95% CI = 1.06-1.51]). Among women without a history of gestational diabetes, the IRR for type 2 diabetes among women who ever had a preterm birth was 1.17 (1.07-1.28).
Conclusion:
Preterm birth was associated with an increased type 2 diabetes risk in black mothers, independent of gestational diabetes.
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