Skip Navigation



Epidemiologic Reviews Advance Access published online on May 28, 2009
Epidemiologic Reviews, doi:10.1093/ajerev/mxp003
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
31/1/84    most recent
mxp003v3
mxp003v2
mxp003v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Kramer, M. R.
Right arrow Articles by Hogue, C. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kramer, M. R.
Right arrow Articles by Hogue, C. R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Epidemiologic Reviews © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Article

What Causes Racial Disparities in Very Preterm Birth? A Biosocial Perspective

Michael R. Kramer and Carol R. Hogue

Correspondence to Dr. Michael R. Kramer, Rollins School of Public Health, Emory University, 1518 Clifton Road, Room 257-C, Atlanta, GA 30322 (e-mail: mkram02{at}sph.emory.edu).

accepted for publication April 15, 2009.

Very preterm birth (<32 weeks’ gestation) occurs in approximately 2% of livebirths but is a leading cause of infant mortality and morbidity in the United States. African-American women have a 2-fold to 3-fold elevated risk compared with non-Hispanic white women for reasons that are incompletely understood. This paper reviews the evidence for the biologic and social patterning of very preterm birth, with attention to leading hypotheses regarding the etiology of the racial disparity. A systematic review of the literature in the MEDLINE, CINAHL, PsycInfo, and EMBASE indices was conducted. The literature to date suggests a complex, multifactorial causal framework for understanding racial disparities in very preterm birth, with maternal inflammatory, vascular, or neuroendocrine dysfunction as proximal pathways and maternal exposure to stress, racial differences in preconceptional health, and genetic, epigenetic, and gene-environment interactions as more distal mediators. Interpersonal and institutionalized racism are mechanisms that may drive racially patterned differences. Current literature is limited in that research on social determinants and biologic processes of prematurity has been generally disconnected. Improved etiologic understanding and the potential for effective intervention may come with better integration of these research approaches.

continental population groups • health status disparities • pregnancy complications, infectious • premature birth

CRH, corticotropin-releasing hormone • VPT, very preterm


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Epidemiol RevHome page
S. A. James
Epidemiologic Research on Health Disparities: Some Thoughts on History and Current Developments
Epidemiol. Rev., November 1, 2009; 31(1): 1 - 6.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.