title: Maternal weathering and risk of preterm delivery.
abstract: OBJECTIVE
  We compared the association between advancing maternal age and risk of preterm delivery across 4 groups (Black smokers, Black nonsmokers, White smokers, White nonsmokers) and within the context of neighborhood deprivation levels.
  
  
  METHODS
  We obtained data from linked census and birth records for singletons (n = 182 938) delivered by women aged 20 to 39 years in Philadelphia, Pennsylvania; Baltimore, Maryland; 16 Michigan cities; 3 Maryland counties; and 2 North Carolina counties. Results from area-specific multilevel logistic regression models were combined to obtain pooled estimates of relations between maternal age and risk of preterm delivery. We repeated the models after categorizing women by neighborhood deprivation level (low, medium, and high).
  
  
  RESULTS
  Among multiparous women, there was a significant age-related increase in preterm delivery in 3 of the 4 groups. The adjusted odds ratio per 5-year age increase was 1.31 in Black smokers, 1.11 in Black nonsmokers, and 1.16 in White smokers. In each group, the odds ratio increased as neighborhood deprivation increased.
  
  
  CONCLUSIONS
  These results support the "weathering" hypothesis, suggesting that Black women, women with high-risk behaviors, and women living in high-deprivation neighborhoods may develop "accelerated aging" that increases preterm delivery risk.
authors.affiliation: Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA. cholzman@epi.msu.edu
authors.forename: Claudia
authors.initials: C
authors.lastname: Holzman
authors.forename: Janet
authors.initials: J
authors.lastname: Eyster
authors.forename: Mary
authors.initials: M
authors.lastname: Kleyn
authors.forename: Lynne C
authors.initials: LC
authors.lastname: Messer
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Laraia
authors.forename: Patricia
authors.initials: P
authors.lastname: O'Campo
authors.forename: Jessica G
authors.initials: JG
authors.lastname: Burke
authors.forename: Jennifer
authors.initials: J
authors.lastname: Culhane
authors.forename: Irma T
authors.initials: IT
authors.lastname: Elo
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008396:Maryland / Q000453:epidemiology; D008429:Maternal Welfare / Q000706:statistics & numerical data*; D008824:Michigan / Q000453:epidemiology; D015233:Models, Statistical; D015999:Multivariate Analysis; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D010414:Pennsylvania / Q000453:epidemiology; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology* / Q000208:ethnology; D012111:Residence Characteristics; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
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