A population study of the contribution of medical comorbidity to the risk of prematurity in blacks

Objective: The purpose of this study was to test the hypothesis that the higher prevalence of medical comorbidities among black women accounts for their increased risk of prematurity. Study Design: A population-based regional cohort of women receiving obstetric care for singleton pregnancies at a large community hospital between 2003 and 2006 were analyzed using univariate and multivariable logistic regression. Results: Data for 18,624 consecutive births found increased odds of adverse outcomes for black compared to white women: prematurity OR = 1.6 (1.4-1.8), extreme prematurity OR = 2.5 (2.0-3.2). Logistic regression modeling identified black race, age < 20, preconception diabetes and hypertension, smoking, underweight, and gestational hypertension as the greatest risks for adverse outcomes. Controlling for these risks did not attenuate the higher risk for prematurity among blacks. Conclusion: Though there is a greater burden of health risk among black women, this did not account for the higher rates of low birthweight and prematurity.