Self-reported experiences of racial discrimination and black-white differences in preterm and low-birthweight deliveries: The CARDIA study

Objectives. We examined the effects of self-reported experiences of racial discrimination on Black-White differences in preterm (less than 37 weeks gestation) and low-birthweight (less than 2500 g) deliveries. Methods. Using logistic regression models, we analyzed data on 352 births among women enrolled in the Coronary Artery Risk Development in Young Adults Study. Results. Among Black women, 50% of those with preterm deliveries and 61% of those with low-birthweight infants reported having experienced racial discrimination in at least 3 situations; among White women, the corresponding percentages were 5% and 0%. The unadjusted odds ratio for preterm delivery among Black versus White women was 2.54 (95% confidence interval [Cl] = 1.33, 4.85), but this value decreased to 1.88 (95% Cl = 0.85, 4.12) after adjustment for experiences of racial discrimination and to 1.11 (95% Cl = 0.51, 2.41) after additional adjustment for alcohol and tobacco use, depression, education, and income. The corresponding odds ratios for low birthweight were 4.24 (95% Cl = 1.31, 13.67), 2.11 (95% Cl = 0.75, 5.93), and 2.43 (95% Cl = 0.79, 7.42). Conclusions. Self-reported experiences of racial discrimination were associated with preterm and low-birthweight deliveries, and such experiences may contribute to Black-White disparities in perinatal outcomes.