title: Preterm birth among American Indian/Alaskan natives in Washington and Montana: comparison with non-Hispanic Whites.
abstract: Preterm birth is the single most important cause of perinatal mortality in North America. Given that American Indians/Alaskan Natives (AI/ANs) in the United States continue to have adverse birth outcomes, the purpose of this study is to compare the risk of preterm birth among AI/AN mothers to Non-Hispanic White mothers living in Washington and Montana from 2003 to 2009. A population-based retrospective cohort study was conducted examining the association between AI/AN mothers (self-reported) and the risk of preterm birth (gestational age <37 weeks) using birth certificate data from Washington and Montana. All AI/AN singleton lives births (n = 26,648) from residents of Washington and Montana from 2003 to 2009 were identified and included in our study. An identical number of Non-Hispanic White singleton infants (n = 26,648) born to residents of Washington and Montana were randomly selected as a comparison group and logistic regression was used to analyze the data. AI/AN mothers living in Washington and Montana between 2003 and 2009 were 1.34 times (95 % CI 1.25-1.44) as likely to have a preterm birth compared to Non-Hispanic Whites after adjusting for maternal and paternal characteristics as well as pregnancy risk factors. AI/AN mothers residing in Washington and Montana from 2003 to 2009 were at a significantly increased risk of having a preterm birth compared to Non-Hispanic Whites. Identifying etiologic differences in preterm birth experienced by AI/ANs is essential in targeting future interventions.
authors.affiliation: University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98102, USA, melhwang@uw.edu.
authors.forename: Melody
authors.initials: M
authors.lastname: Hwang
authors.forename: Archana
authors.initials: A
authors.lastname: Shrestha
authors.forename: Sheldwin
authors.initials: S
authors.lastname: Yazzie
authors.forename: Michael L
authors.initials: ML
authors.lastname: Jackson
mesh_terms: D000328:Adult; D000413:Alaska; D001719:Birth Certificates; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000208:ethnology*; D007223:Infant; D007231:Infant, Newborn; D004930:Inuit / Q000208:ethnology*; D016015:Logistic Models; D009009:Montana / Q000453:epidemiology; D009035:Mothers; D011247:Pregnancy; D047928:Premature Birth / Q000208:ethnology*; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States; D014861:Washington / Q000453:epidemiology; D044465:White People / Q000208:ethnology*; D055815:Young Adult