title: Ethnic disparities in the risk of adverse neonatal outcome after spontaneous preterm birth.
abstract: OBJECTIVE
  To describe ethnic disparities in the risk of spontaneous preterm birth and related adverse neonatal outcome.
  
  
  METHODS
  Nationwide prospective cohort study.
  
  
  METHODS
  The Netherlands, 1999-2007.
  
  
  METHODS
  Nine hundred and sixty-nine thousand, four hundred and ninety-one singleton pregnancies with a spontaneous onset of labor.
  
  
  METHODS
  We investigated ethnic disparities in perinatal outcome for European white, African, South-Asian, Mediterranean and East-Asian women. We performed multivariate logistic regression analyses to calculate the adjusted odds ratio (aOR) and confidence intervals (CIs) of spontaneous preterm birth and the risk of subsequent neonatal morbidity and mortality.
  
  
  METHODS
  The primary outcome measure was spontaneous preterm birth before 37 completed weeks of gestation. Secondarily, we investigated subsequent adverse neonatal outcome, which was a composite outcome of intraventricular hemorrhage, bronchopulmonary dysplasia, infant respiratory distress syndrome, neonatal sepsis or neonatal mortality within 28 days after birth.
  
  
  RESULTS
  Compared with European whites, the aOR of delivering preterm was 1.33 (95% CI 1.26-1.41) for African women, 1.58 (95% CI 1.47-1.69) for South-Asians, 0.88 (95% CI 0.84-0.91) for Mediterraneans and 1.04 (95% CI 0.98-1.11) for East-Asians. Subsequent odds of adverse neonatal outcome were significantly lower for African (aOR 0.51; 95% CI 0.41-0.64) and Mediterranean women (aOR 0.86; 95% CI 0.75-0.99) when compared with European whites.
  
  
  CONCLUSIONS
  African and South-Asian women are at higher risk for preterm birth than European white women. However, the harmful effect of preterm birth on neonatal outcome is less severe for these women.
authors.affiliation: Departments of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands. j.m.schaaf@amc.uva.nl
authors.forename: Jelle M
authors.initials: JM
authors.lastname: Schaaf
authors.forename: Ben-Willem J
authors.initials: BW
authors.lastname: Mol
authors.forename: Ameen
authors.initials: A
authors.lastname: Abu-Hanna
authors.forename: Anita C J
authors.initials: AC
authors.lastname: Ravelli
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D047928:Premature Birth / Q000208:ethnology*; D011446:Prospective Studies; D012042:Registries; D012306:Risk