Preterm delivery trends by maternal race/ethnicity in the United States, 2006-2012

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Epidemiology

Background:

• Preterm delivery (PTD) remains a significant concern in the United States, impacting infant health and healthcare costs.
• Understanding trends in PTD by clinical circumstance and demographic factors is crucial for targeted interventions.

Purpose of the Study:

• To estimate changes in preterm delivery (PTD) rates in the US from 2006 to 2012.
• To analyze these changes by clinical circumstance (spontaneous vs. medically indicated) and timing of delivery.
• To examine PTD trends across different racial and ethnic groups.

Main Methods:

• Utilized vital statistics natality data for singleton live births in 18 US states (2006-2012).
• Employed descriptive and multivariable regression methods to estimate changes in PTD.
• Analyzed PTD rates overall, by clinical circumstance, delivery timing, and race/ethnicity.

Main Results:

• Overall PTD decreased by 10.31%, with spontaneous PTD declining by 11.52% and indicated PTD by 8.40%.
• Significant decreases were observed in late-preterm, early-term, and post-term deliveries, with a concurrent increase in full-term deliveries.
• Declines in PTD varied by race/ethnicity, with Non-Hispanic white, Non-Hispanic black, and Asian/Pacific Islander women showing larger reductions compared to Hispanic and American Indian/Alaska Native women.

Conclusions:

• Preterm delivery rates declined between 2006 and 2012, across spontaneous and indicated categories.
• The observed declines were less substantial than previously reported.
• Significant racial and ethnic disparities persist in PTD trends, necessitating further investigation and tailored public health strategies.