• Posted August 7, 2023

Rate of Preterm Births Is Higher for Black Americans

Black women have significantly more preterm births than white women do, and though almost a third of these extra cases can be explained by heart issues and social factors, the rest remain a mystery.

However, targeting those known factors could improve birth outcomes, a new study suggests. Social determinants of health include factors such as income, education, insurance and access to care.

“This is important because this represents a large number of individuals who are being born early every year that have much higher risk for bad health outcomes and is significantly different between non-Hispanic Black and white individuals,” said corresponding author Dr. Sadiya Khan, a cardiologist and assistant professor of medicine at Northwestern University Feinberg School of Medicine in Chicago.

Greater numbers of preterm births in Black women contribute to health disparities throughout life. Premature babies have more heart disease as adults. Being born early is also linked to developmental delays.

Researchers found that in 2019, nearly 12% of Black people had preterm births compared with 7% of white people.

Heart health before pregnancy explained 8% of this. Social determinants were responsible for another 20% of the racial gap.

Researchers said this is the first study that helps explain which of the individual-level maternal health factors, including obesity, diabetes and high blood pressure, and socioeconomic factors such as including insurance, prenatal care and education, can be targeted to improve birth outcomes.

“Differences that occur when someone is born early can have important implications not just for the first year of life, but also throughout their life,” Khan said in a university news release.

Researchers included data from more than 2 million people who had a live birth in 2019. It also used information from birth registration records from the U.S. National Center for Health Statistics, which collects data on all live births.

“Preterm birth is the starting point for racial differences across the life course, not just in childhood,” Khan said.

She expressed concern about the recent loss of Medicaid for millions of Americans.

“If you don't have health insurance when you become pregnant, you are much less likely to get prenatal or cardiovascular care,” Khan said. “Prenatal care in the first trimester is critical to improving birth outcomes.”

She called for better understanding all of the differences.

“We need to understand the problem so we can fix it,” Khan said. “Understanding racial differences in preterm birth is critical to identifying opportunities for prevention and awareness.”

The research was funded by a grant from the U.S. National Heart, Lung, and Blood Institute. The study was published Aug. 7 in the American Journal of Preventive Medicine.

More information

The March of Dimes has more on premature birth.

SOURCE: Northwestern University, news release, Aug. 7, 2023