Maternal weathering and risk of preterm delivery.
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.
Holzman
Claudia
C
Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA. cholzman@epi.msu.edu
Eyster
Janet
J
Kleyn
Mary
M
Messer
Lynne C
LC
Kaufman
Jay S
JS
Laraia
Barbara A
BA
O'Campo
Patricia
P
Burke
Jessica G
JG
Culhane
Jennifer
J
Elo
Irma T
IT
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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