title: Transgenerational Transmission of Preterm Birth Risk: The Role of Race and Generational Socio-Economic Neighborhood Context.
abstract: Objectives We investigated associations of mothers' preterm birth (PTB) status with her infants' PTB risk. We also examined whether this relationship differs by mothers' race and generational socio-economic neighborhood context. Methods Participants were 6592 non-Hispanic (NH) white and NH black mother-infant pairs born in 2009-2011 and 1979-1998, respectively, in Allegheny County, Pennsylvania. Birth records were used to determine gestational age at birth, PTB status (<37 completed weeks of gestation), and PTB subgroups-late and early PTB (34-36 weeks and <34 completed weeks of gestation, respectively). Census data on tract racial composition and household income were used to characterize residential race and economic environment. Logistic regression models were used to calculate Odds Ratios (ORs), Relative Risk Ratios (RRR), and 95% confidence intervals (CIs). Stratified analyses were conducted to assess effect modification. Results Overall, 8.21, 6.63 and 1.58% infants had PTB, LPTB, and EPTB, respectively. Maternal PTB status was associated with a 46% increase in infant PTB (95% CI: 1.08-1.98), EPTB (95% CI: 0.80-2.69), and LPTB (95% CI: 1.04-2.04) risk. Maternal PTB-infant PTB associations, particularly maternal PTB-infant LPTB associations, were stronger among NH blacks, mothers in neighborhoods with a high percentage of NH black residents in both generations, or mothers who moved to neighborhoods with a higher percentage of NH black residents. Conclusions for Practice Race and generational socio-economic neighborhood context modify transgenerational transmission of PTB risk. These findings are important for identification of at-risk populations and to inform future mechanistic studies.
authors.affiliation: Department of Epidemiology, School of Public Health, University of Washington, 1959 NE Pacific Street, Health Sciences Building, Seattle, WA, 98195-7236, USA. ncubec@u.washington.edu.
authors.forename: Collette N
authors.identifier: http://orcid.org/0000-0002-0661-9926
authors.initials: CN
authors.lastname: Ncube
authors.affiliation: Department of Epidemiology, School of Public Health, University of Washington, 1959 NE Pacific Street, Health Sciences Building, Seattle, WA, 98195-7236, USA.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Enquobahrie
authors.affiliation: Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15261, USA.
authors.forename: Jessica G
authors.initials: JG
authors.lastname: Burke
authors.affiliation: Department of Psychology in Education, School of Education, University of Pittsburgh, 5930 Wesley W. Posvar Hall, Pittsburgh, PA, 15260, USA.
authors.forename: Feifei
authors.initials: F
authors.lastname: Ye
authors.affiliation: Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15261, USA.
authors.forename: John
authors.initials: J
authors.lastname: Marx
authors.affiliation: Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15261, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Albert
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D005865:Gestational Age; D054624:Health Status Disparities; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D016901:Intergenerational Relations; D009035:Mothers; D010414:Pennsylvania; D011247:Pregnancy; D047928:Premature Birth / Q000208:ethnology*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data
keywords: Intergenerational; Neighborhood; Preterm birth; Socio-economic status; Transgenerational