title: A population-based case-control study of stillbirth: the relationship of significant life events to the racial disparity for African Americans.
abstract: Stillbirths (fetal deaths occurring at ≥20 weeks' gestation) are approximately equal in number to infant deaths in the United States and are twice as likely among non-Hispanic black births as among non-Hispanic white births. The causes of racial disparity in stillbirth remain poorly understood. A population-based case-control study conducted by the Stillbirth Collaborative Research Network in 5 US catchment areas from March 2006 to September 2008 identified characteristics associated with racial/ethnic disparity and interpersonal and environmental stressors, including a list of 13 significant life events (SLEs). The adjusted odds ratio for stillbirth among women reporting all 4 SLE factors (financial, emotional, traumatic, and partner-related) was 2.22 (95% confidence interval: 1.43, 3.46). This association was robust after additional control for the correlated variables of family income, marital status, and health insurance type. There was no interaction between race/ethnicity and other variables. Effective ameliorative interventions could have a substantial public health impact, since there is at least a 50% increased risk of stillbirth for the approximately 21% of all women and 32% of non-Hispanic black women who experience 3 or more SLE factors during the year prior to delivery.
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA. chogue@emory.edu
authors.forename: Carol J R
authors.initials: CJ
authors.lastname: Hogue
authors.forename: Corette B
authors.initials: CB
authors.lastname: Parker
authors.forename: Marian
authors.initials: M
authors.lastname: Willinger
authors.forename: Jeff R
authors.initials: JR
authors.lastname: Temple
authors.forename: Carla M
authors.initials: CM
authors.lastname: Bann
authors.forename: Robert M
authors.initials: RM
authors.lastname: Silver
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Dudley
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Koch
authors.forename: Donald R
authors.initials: DR
authors.lastname: Coustan
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Stoll
authors.forename: Uma M
authors.initials: UM
authors.lastname: Reddy
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: George R
authors.initials: GR
authors.lastname: Saade
authors.forename: Deborah
authors.initials: D
authors.lastname: Conway
authors.forename: Robert L
authors.initials: RL
authors.lastname: Goldenberg
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D016001:Confidence Intervals; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D007348:Insurance, Health; D008016:Life Change Events; D017533:Marital Status; D016017:Odds Ratio; D011247:Pregnancy; D012307:Risk Factors; D050497:Stillbirth / Q000208:ethnology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*