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Updated: Oct 10, 2026

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Racial inequalities in preterm birth in Central-West Brazil, 2015-2024: a population-based cross-sectional study
Guilherme Coelho1, Charles M'poca Charles2, Rodolfo de Carvalho Pacagnella2
1Universidade Estadual de Campinas. Faculdade de Ciências Médicas. Programa de Pós-Graduação em Tocoginecologia. Campinas, SP, Brasil.
Objective:
To examine racial inequalities in preterm birth (PTB; < 37 weeks) among White, Parda, Black, and Indigenous mothers in Brazil's Central-West region using a population-based cross-sectional design.
Methods:
We analyzed 2,156,674 live births registered in Sistema de Informação sobre Nascidos Vivos (2015-2024) across Goiás, Mato Grosso, Mato Grosso do Sul, and the Federal District. Logistic regression with progressive covariate adjustment estimated odds ratios, with White mothers as the reference group; prevalence ratios from Poisson regression with robust variance, adjusted probabilities by group, and absolute risk differences were estimated as complementary measures.
Results:
Crude preterm birth prevalence was 11.1% (White), 11.0% (Parda), 11.7% (Black), and 17.6% (Indigenous). In the primary sociodemographic model, Indigenous mothers had 50.4% higher odds (OR = 1.504; 95% CI 1.461-1.549), corresponding to a 28.9% attenuation of the crude OR. The adjusted probability of preterm birth was 15.9% among Indigenous versus 11.2% among White mothers (absolute difference 4.7 percentage points; prevalence ratio 1.41). In exploratory models additionally adjusting for prenatal care, parity, and marital status (n = 2,146,853), the Indigenous OR was attenuated to 1.222 (95% CI 1.186-1.259), although adjustment for prenatal visits is susceptible to reverse causation. Black mothers showed a modest crude excess (OR = 1.053) that did not persist after adjustment (full model OR = 0.973), and Parda mothers showed slightly lower odds throughout.
Conclusion:
Indigenous mothers in the Central-West experience a substantial preterm birth inequality that is only partially attenuated by measured sociodemographic factors and is compatible with the influence of unmeasured structural and contextual determinants.
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