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Updated: Aug 2, 2025

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Resilience as a potential modifier of racial inequities in preterm birth
Allyson M Redhunt1, Rachel Ledyard2, Ai-Ris Y Collier3
1Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA; Department of Medical Education, Tufts University School of Medicine, Boston, MA; Department of Medical Education, Maine Medical Center, Portland, ME.
Purpose:
In the US, preterm birth (PTB) is 55% more common among Black compared to White individuals and psychosocial stressors may contribute. Resilience is associated with improved health outcomes; whether it modifies PTB inequity is unknown. We hypothesized high resilience would reduce inequities in PTB risk.
Methods:
This study analyzes data from 535 pregnancies among Black (n = 101, 19%) and White (n = 434, 81%) participants from a prospective cohort. Participants completed the Connor-Davidson Resilience Scale. We calculated risk ratios (RR) stratified by resilience tertiles to test for effect measure modification.
Results:
Among those in the lowest resilience tertile, there were six (20.7%) PTBs among Black and seven (4.9%) among White participants (RR: 4.26; 95% confidence interval (CI): 1.53, 11.81). Among those in the highest resilience tertile, there were 8 (18.2%) PTBs among Black and 14 (9.5%) among White participants (RR: 1.92; 95% CI: 0.87, 4.24. The adjusted Black:White RR was 2.00 (95% CI 0.47, 8.64) in the lowest and 3.49 (95% CI 1.52, 8.01) in the highest tertile.
Conclusions:
Black-White PTB inequity did not differ among resilience strata and remained significant in the highest tertile. Our findings suggest that high resilience is inadequate to overcome Black:White racial inequity in PTB.
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