Racial and ethnic disparity in male preterm singleton birth. 2011

Edward K Chien, and Asha Jayakrishnan, and Tanya L Dailey, and Christina A Raker, and Maureen G Phipps
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women & Infants' Hospital of Rhode Island, Providence, RI 02905, USA. echien@wihri.org

OBJECTIVE To evaluate the association between male sex and increased preterm birth (PTB) by race and ethnicity among singleton fetuses born in the United States. METHODS The 2002 National Center for Health Statistics Natality database was analyzed for known risk factors of PTB by fetal sex and race. Multivariable Cox proportional hazards regression was applied to estimate the hazard ratio by fetal sex for births between 20 and 36 completed gestational weeks. The multivariable model was adjusted for known demographic, medical and obstetric risk factors for PTB. Subgroup analysis was performed using both race and ethnicity. RESULTS In the overall analysis 3,853,678 singleton live births were included. PTBs between 20 and 36 completed weeks occurred in 10.9% of male and 9.8% of female infants. The association between PTB and male sex persisted after adjustment for other risk factors and did not vary by gestational age (hazard ratio [HR] 1.13, 95% CI 1.12-1.14). This association was seen in all racial and ethnic groups. This effect was less prominent among black infants (HR 1.06, 95% CI 1.04-1.07). Male fetuses with Hispanic ethnicity had a significantly higher risk of preterm birth (HR 1.15, 95% CI 1.13-1.17) compared to male fetuses of non-Hispanic ethnicity (HR 1.12, 95% CI 1.12-1.13). CONCLUSIONS In the U.S. male fetuses are at higher risk for PTB compared with female fetuses at the same gestational age. The etiology of this difference is unclear, but the effect is reduced for black compared to white fetuses and increased for Hispanic fetuses.

UI MeSH Term Description Entries
D008297 Male Males
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D001724 Birth Weight The mass or quantity of heaviness of an individual at BIRTH. It is expressed by units of pounds or kilograms. Birthweight,Birth Weights,Birthweights,Weight, Birth,Weights, Birth
D001741 Black or African American A person having origins in any of the black racial groups of Africa (https://www.federalregister.gov/documents/1997/10/30/97-28653/revisions-to-the-standards-for-the classification-of-federal-data-on-race-and-ethnicity). In the United States it is used for classification of federal government data on race and ethnicity. Race and ethnicity terms are self-identified social construct and may include terms outdated and offensive in MeSH to assist users who are interested in retrieving comprehensive search results for studies such as in longitudinal studies. African American,African Americans,African-American,Afro-American,Afro-Americans,Black Americans,Blacks,Negroes,African-Americans,Negro,Afro American,Afro Americans,American, African,American, Black,Black American
D005006 Ethnicity A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. Ethnic Groups,Nationality,Ethnic Group,Nationalities
D005260 Female Females
D005865 Gestational Age The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated from the onset of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization. It is also estimated to begin from fertilization, estrus, coitus, or artificial insemination. Embryologic Age,Fetal Maturity, Chronologic,Chronologic Fetal Maturity,Fetal Age,Maturity, Chronologic Fetal,Age, Embryologic,Age, Fetal,Age, Gestational,Ages, Embryologic,Ages, Fetal,Ages, Gestational,Embryologic Ages,Fetal Ages,Gestational Ages
D006630 Hispanic or Latino A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race (https://www.federalregister.gov/documents/1997/10/30/97-28653/revisions-to-the-standards-for-the-classification-of-federal-data-on-race-and-ethnicity). In the United States it is used for classification of federal government data on race and ethnicity. Race and ethnicity terms are self-identified social construct and may include terms outdated and offensive in MeSH to assist users who are interested in retrieving comprehensive search results for studies such as in longitudinal studies. Cuban Americans,Hispanic Americans,Latin Americans, US,Latinas,Latinos,Latinx,Puerto Ricans,Spanish Americans,Hispanics,American, Hispanic,American, US Latin,Cuban American,Hispanic American,Hispanic or Latinos,Latin American, US,Latina,Latino,Puerto Rican,Spanish American,US Latin American,US Latin Americans
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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