Ethnicity and Pregnancy Outcomes in New York City

描述（由申请人提供）：美国的主要种族群体（非裔美国人、拉丁裔和亚洲人）表现出独特的妊娠结局模式，包括早产、低出生体重和婴儿死亡率。许多报告对此进行了描述，但几乎没有努力扩展这些观察结果以解决这些模式背后可能的因果路径。为了加深我们对种族和社会经济条件对妊娠结局的影响的理解，我们建议分析 1998 年至 2002 年期间纽约市的出生情况，这一时期横跨 2000 年人口普查的 5 年期间，最终分析中纳入了超过 500,000 名出生人口。通过这些数据源的组合，我们将：描述妊娠结局的种族模式，包括早产、生长受限和常见妊娠并发症，描述不同种族妇女的危险因素，包括社会人口特征，如年龄、婚姻状况和教育程度，以及影响妊娠结局的一些医疗状况。个人层面的种族衡量包括种族、西班牙裔、出生地和血统，考虑到纽约市人口的规模和多样性，我们将能够识别和分析细化的亚群体（例如波多黎各人、亚洲印度人、韩国人）。我们将进行多层次的统计分析，考虑出生证明中的个人属性和美国人口普查中的社区特征，以检验它们的单独和联合效应，重点关注种族、社会经济地位、出生地和人口普查区域内种族集中度的影响。通过更全面地阐明种族与妊娠结局之间的关系，更详细地考虑更广泛的种族，并整合个人和社区层面的社会经济影响，我们将能够更好地针对需要干预的群体并确定病因线索。

DESCRIPTION (provided by applicant): The major ethnic groups in the United States, African-Americans, Latinos, and Asians, show distinctive patterns of pregnancy outcome, including preterm birth, low birth weight, and infant mortality. Numerous reports have described this, but there has been little effort to extend these observations to address possible causal pathways underlying the patterns. In order to extend our understanding of the role of ethnicity and socioeconomic conditions on pregnancy outcome, we propose to analyze births in New York City over the period 1998-2002, a 5-year period straddling the 2000 Census, with over 500,000 births included in the final analysis. Through this combination of data sources, we will: describe ethnic patterns of pregnancy outcome, including preterm birth, growth restriction, and common pregnancy complications, characterize risk factors among women of varying ethnicity, including sociodemographic characteristics such as age, marital status, and education, and a number of medical conditions affecting the outcome of pregnancy. Measures of ethnicity at the individual level include race, Hispanic ethnicity, nativity, and ancestry, and we will be able to identify and analyze refined subgroups (e.g., Puerto Ricans, Asian Indians, Koreans) given the size and diversity of the New York City population. We will conduct a multi-level statistical analysis that takes into account both individual attributes from the birth certificate and neighborhood features from the US Census to examine their separate and joint effects, focusing on the influence of ethnicity, socioeconomic status, nativity, and concentration of ethnicity within Census Tracts. By elucidating the relationship between ethnicity and pregnancy outcome more fully, considering a broader range of ethnicities defined in greater detail, and integrating individual and community level socioeconomic influences, we will be better able to target groups in need of intervention as well as identify clues to etiology.