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Risk and Protective Factors for Preterm Birth Among Racial, Ethnic, and Socioeconomic Groups in California.

Laura L Jelliffe-Pawlowski1,2,3,4,5,6, Rebecca J Baer3,4,5,7,8, Scott Oltman1,2,3,4

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Preterm birth rates increased overall from 2011 to 2022, with persistent racial and socioeconomic disparities. Changes in risk and protective factors offer insights into these trends, highlighting an urgent need for interventions.

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Area of Science:

  • Reproductive Health
  • Public Health
  • Epidemiology

Background:

  • Preterm birth (PTB) is a leading cause of infant mortality and morbidity in the US.
  • Significant racial, ethnic, and socioeconomic inequities are associated with PTB rates.
  • Further research is needed to understand risk and protective factors influencing PTB trends and inequities.

Purpose of the Study:

  • To examine the association of preterm birth (PTB) rates with inequities.
  • To identify related risk and protective factors over the past decade in a US population-based cohort.
  • To describe trends in PTB rates and associated inequities.

Main Methods:

  • Retrospective cohort study of singleton live births in California (2011-2022).
  • Utilized vital statistics and hospital records for births with gestational age 22-44 weeks.
  • Analyzed PTB rates by racial/ethnic groups and insurance status (proxy for SES) using log-linear regression.

Main Results:

  • Overall PTB rate increased from 6.8% to 7.5% between 2011 and 2022.
  • Observed persistent racial, ethnic, and socioeconomic disparities in PTB rates.
  • Identified increases in risk factors (e.g., diabetes, STIs) and decreases in protective factors (e.g., WIC participation) in certain groups.

Conclusions:

  • Preterm birth rates have risen in many groups, with ongoing racial and socioeconomic inequities.
  • Changes in risk and protective factors correlate with PTB patterns.
  • Urgent interventions are needed at individual and population levels to address PTB factors.