Preterm birth affects women in all ethnic groups, but in the U.S. African-Americans are nearly twice as likely to give birth prematurely.
Many researchers have tried to determine why this is so. The World Health Organization indicates that preterm birth is the primary cause of infant mortality worldwide.
One possible way to understand this disparity is to consider the physiological effect of racism and cumulative adversities on African-American women and their offspring.
Can racism, poverty, psychological trauma, depression, and other adversities increase the risk of preterm birth?
Research studies suggest that those factors can and do have a negative effect.
Trauma, Inflammation, and Racial/Ethnic Health Disparities
Rooted In Our Biology: Psychoneuroimmunology and the Frontiers of Mind-Body Medicine
A new paradigm for depression in new mothers: the central role of inflammation and how breastfeeding and anti-inflammatory treatments protect maternal mental health
Addressing Racial and Ethnic Health Disparities in Infant Mortality Additional Barriers to Care
Breastfeeding support for mothers of preterm babies is particularly important. African-American mothers who have preterm babies may encounter even more barriers. According to the Centers for Disease Control and Prevention, higher rates of breastfeeding mean lower rates of infant mortality.
Disparities in Breastfeeding: Impact on Maternal and Child Health Outcomes and Costs presents the results of a study aiming to estimate the disease burden and associated costs attributable to suboptimal breastfeeding rates among non-Hispanic blacks (NHBs), Hispanics, and non-Hispanic whites (NHWs). Using current literature on associations between breastfeeding and health outcomes for eight pediatric and five maternal diseases, researchers used Monte Carlo simulations to evaluate two hypothetical cohorts of U.S. women followed from age 15 to 70 years and their infants followed from birth to age 20 years.
The research concluded that compared with a NHW population, a NHB population had 1.7 times the number of excess cases of acute otitis media attributable to suboptimal breastfeeding, 3.3 times the number of excess cases of necrotizing enterocolitis, and 2.2 times the number of excess child deaths. Compared with a NHW population, a Hispanic population had 1.4 times the number of excess cases of gastrointestinal infection and 1.5 times the number of excess child deaths.