Racial and ethnic differences in determinants of intrauterine growth retardation and other compromised birth outcomes
Racial and ethnic differences in determinants of intrauterine growth retardation and other compromised birth outcomes
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DOI：
10.2105/ajph.87.12.1977
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发表时间：
1997-12-01
影响因子：
12.7
通讯作者：
Pullum, SG
中科院分区：
文献类型：
--
作者：
Frisbie, WP;Biegler, M;Pullum, SG
目标。这项研究考察了不良出生结局发生率按种族/民族的差异程度，在控制其他危险因素后，差异是否持续，以及关系的方向和大小是否因结果类型而不同。在一个具有全国代表性的大型美国数据集中，我们使用一个修正的测量系统来估计多项Logistic模型。在不同的出生结果类别中发现了相当大的种族/民族差异；调整后的参数估计仍然存在差异；其他风险因素对出生结果的影响在方向上相似，但在幅度上略有不同。非裔美国人出生结局受损的几率比墨西哥裔美国人和非西班牙裔白人高得多。除了持续存在的种族不平等，我们还发现，不充分和“适当”的产前护理和吸烟都会产生强烈的不良影响。在没有医疗保险的情况下，胎儿宫内发育迟缓的风险较高，而在参加妇女、婴儿和儿童特别补充食品计划的母亲中，所有不良生育结果的风险都较低。
Objectives. This study examined the extent of variation by race/ethnicity in the prevalence of adverse birth outcomes, whether differentials persisted after other risk factors were controlled for, and whether the direction and magnitude of relationships differed by type of outcome.Methods. A revised system of measurement was used to estimate multinomial logistic models in a large, nationally representative US data set.Results. Considerable racial/ethnic variation was found across birth outcome categories; differences persisted in the adjusted parameter estimates; and the effects of other risk factors on birth outcomes were similar as to direction, but varied somewhat in magnitude. The odds of compromised birth outcomes were much higher among African Americans than among Mexican Americans and non-Hispanic Whites.Conclusions. In addition to persistent racial inequality, we found strong adverse effects of both inadequate and "adequate-plus" prenatal care and smoking. Risk of intrauterine growth retardation was higher in the absence of medical insurance, and risk of all adverse birth outcomes was lower among mothers participating in the Special Supplemental Food Program for Women, Infants, and Children.