Racial disparities in recurrent preterm delivery risk: mediation analysis of prenatal care timing

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Khalidha Nasiri ◽  
Erica E. M. Moodie ◽  
Haim A. Abenhaim
Keyword(s):  
Prenatal Care ◽  
Racial Disparities ◽  
Preterm Delivery ◽  
Mediation Analysis ◽  
Hispanic Women ◽  
Population Based ◽  
Mediating Effect ◽  
Care Visit ◽  
Binomial Regression ◽  
Prenatal Care Visit

AbstractObjectivesWe estimated the degree to which the association between race and spontaneous recurrent preterm delivery is mediated by the timing of the first prenatal care visit.MethodsA retrospective population-based cohort study was conducted using the U.S. National Center for Health Statistics Natality Files. We identified 644,576 women with a prior PTB who delivered singleton live neonates between 2011 and 2017. A mediation analysis was conducted using log-binomial regression to evaluate the mediating effect of timing of first prenatal care visit.ResultsDuring the seven-year period, 349,293 (54.2%) White non-Hispanic women, 131,296 (20.4%) Black non-Hispanic women, 132,367 (20.5%) Hispanic women, and 31,620 (4.9%) Other women had a prior preterm delivery. The risk of late prenatal care initiation was higher in Black non-Hispanic women, Hispanic women, and Other women (women of other racial/ethnic backgrounds) compared to White non-Hispanic women, and the risk of preterm delivery was higher in women with late prenatal care initiation. Between 8 and 15% of the association between race and spontaneous recurrent preterm delivery acted through the delayed timing of the first prenatal care visit.ConclusionsRacial disparities in spontaneous recurrent preterm delivery rates can be partly, but not primarily, attributed to timing of first prenatal care visit.

scholarly journals Paging “Dr. Google”: Does Technology Fill the Gap Created by the Prenatal Care Visit Structure? Qualitative Focus Group Study With Pregnant Women

2014 ◽  
Vol 16 (6) ◽  
pp. e147 ◽  
Author(s):  
Jennifer L Kraschnewski ◽  
Cynthia H Chuang ◽  
Erika S Poole ◽  
Tamara Peyton ◽  
Ian Blubaugh ◽  
...  
Keyword(s):  
Focus Group ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Focus Group Study ◽  
Care Visit ◽  
Prenatal Care Visit

scholarly journals Why Do Women Delay in Seeking Prenatal Care? A Discrete-Time Survival Analysis

2021 ◽  
Vol 6 (2) ◽  
pp. p1
Author(s):  
Ama A. Abrokwah ◽  
Stephen O. Abrokwah
Keyword(s):  
Health Insurance ◽  
Prenatal Care ◽  
National Health Insurance ◽  
National Health ◽  
Survival Data ◽  
Proportional Hazard ◽  
Care Visit ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Prenatal Care Visit

This paper evaluates the effect of access to the Ghana national health insurance on the timing of the first prenatal care visit for pregnant women after controlling for other factors. Due to the voluntary nature of the national health insurance program, insurance status is likely endogenous, this paper therefore uses the Multilevel Multiprocess (MLMP) model and the Mixed Proportional Hazard (MPH) model estimation techniques, which controls for endogeneity in survival data analysis. Results from the estimation shows that access to insurance reduces the delays in receiving prenatal care, and increases the probability of seeking prenatal care.

Frequency of prenatal care visits by ethnic minority mothers and association with infant birthweight in Bac Kan province, Vietnam

2005 ◽  
Vol 35 (2) ◽  
pp. 103-103 ◽  
Author(s):  
Nguyen Thanh Hien ◽  
Hiroshi Ushijima
Keyword(s):  
Prenatal Care ◽  
Ethnic Minority ◽  
Low Birthweight ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Visit ◽  
Prenatal Care Visit

The objective of this cross-sectional study was to evaluate the association between prenatal care visits and infant birthweight among ethnic minority mothers in the mountainous Bac Kan province. This was done by comparing the frequency and timing of first prenatal care visit of 32 mothers with low birthweight (LBW) infants and 32 mothers with normal birthweight (NBW) infants. During pregnancy, mothers of NBW infants underwent 3.4±1 (mean) prenatal care visits and mothers of LBW infants 2.8±0.9 ( P= 0.02). Mothers of NBW infants underwent their first prenatal care visit at 13.1±5.7 weeks of gestation, one week earlier than mothers of LBW infants. The frequency of prenatal care visit are probably associated with a decreased risk of LBW among ethnic minority mothers in Bac Kan province.

scholarly journals Inequities in utilization of prenatal care: a population-based study in the Canadian province of Manitoba

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Maureen I. Heaman ◽  
Patricia J. Martens ◽  
Marni D. Brownell ◽  
Mariette J. Chartier ◽  
Kellie R. Thiessen ◽  
...  
Keyword(s):  
Prenatal Care ◽  
Population Based ◽  
Canadian Province ◽  
Population Based Study

Prenatal care and preterm birth in the Western Brazilian Amazon: A population-based study

2021 ◽  
pp. 1-12
Author(s):  
Clariana V. Ramos de Oliveira ◽  
Paulo A. R. Neves ◽  
Barbara H. Lourenço ◽  
Rodrigo Medeiros de Souza ◽  
Maíra B. Malta ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Prenatal Care ◽  
Brazilian Amazon ◽  
Population Based ◽  
Population Based Study

scholarly journals Preterm Delivery; Who Is at Risk?

2021 ◽  
Vol 10 (11) ◽  
pp. 2279
Author(s):  
Dvora Kluwgant ◽  
Tamar Wainstock ◽  
Eyal Sheiner ◽  
Gali Pariente
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Prenatal Care ◽  
Recurrent Pregnancy Loss ◽  
Placental Abruption ◽  
Placenta Previa ◽  
Population Based ◽  
Perinatal Morbidity ◽  
Multiple Gestations ◽  
Extremely Preterm

Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality. Adverse effects of preterm birth have a direct correlation with the degree of prematurity, in which infants who are born extremely preterm (24–28 weeks gestation) have the worst outcomes. We sought to determine prominent risk factors for extreme PTB and whether these factors varied between various sub-populations with known risk factors such as previous PTB and multiple gestations. A population-based retrospective cohort study was conducted. Risk factors were examined in cases of extreme PTB in the general population, as well as various sub-groups: singleton and multiple gestations, women with a previous PTB, and women with indicated or induced PTB. A total of 334,415 deliveries were included, of which 1155 (0.35%) were in the extreme PTB group. Placenta previa (OR = 5.8, 95%CI 4.14–8.34, p < 0.001), multiple gestations (OR = 7.7, 95% CI 6.58–9.04, p < 0.001), and placental abruption (OR = 20.6, 95%CI 17.00–24.96, p < 0.001) were the strongest risk factors for extreme PTB. In sub-populations (multiple gestations, women with previous PTB and indicated PTBs), risk factors included placental abruption and previa, lack of prenatal care, and recurrent pregnancy loss. Singleton extreme PTB risk factors included nulliparity, lack of prenatal care, and placental abruption. Placental abruption was the strongest risk factor for extreme preterm birth in all groups, and risk factors did not differ significantly between sub-populations.

Medically indicated late preterm delivery and its impact on perinatal morbidity and mortality: a retrospective population-based cohort study

2018 ◽  
Vol 32 (19) ◽  
pp. 3278-3287 ◽  
Author(s):  
Limor Besser ◽  
Liat Sabag-Shaviv ◽  
Maayan Yitshak-Sade ◽  
Salvatore Andrea Mastrolia ◽  
Danielle Landau ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Delivery ◽  
Population Based ◽  
Late Preterm ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity

scholarly journals Association between systolic blood pressure trajectories and hypertension risk at late adolescence: results from 10-year longitudinal follow-up in Chinese boys

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042594
Author(s):  
Xijie Wang ◽  
Bin Dong ◽  
Sizhe Huang ◽  
Zhaogeng Yang ◽  
Jun Ma ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Late Adolescence ◽  
Population Based ◽  
Incidence Rates ◽  
Hypertension Risk ◽  
Logit Regression ◽  
Binomial Regression ◽  
Physical Examinations

ObjectiveTo identify various systolic blood pressure (SBP) trajectories in Chinese boys between 7 and 18 years of age, and to explore their high blood pressure (HBP) risk in their late adolescence years.Design and settingsA population-based cohort study in Guangdong, China.Participants4541 normal tensive boys who started primary school in 2005 in Zhongshan, Guangdong were included.OutcomesBlood pressure and relevant measurements were obtained by annual physical examinations between 2005 and 2016. HBP was defined by SBP or diastolic blood pressure ≥95th percentile for children under 13, and BP ≥130/80 mm Hg for children ≥13 years old. Logit regression for panel data and log-binomial regression model was used to estimate the risk of HBP among SBP trajectory groups.ResultsFour distinct SBP trajectory groups via group-based trajectory modelling: low stable (13.0%), low rising (42.4%), rising (37.4%) and high rising (7.3%). The overall incidence rates of HBP during the follow-up ranged from 40.24 (95% CI 36.68 to 44.19)/1000 person-years in the low stable group to 97.08 (95% CI 94.93 to 99.27)/1000 person-years in the high rising group. Compared with children with low stable SBP, those of other SBP trajectories suffered 3.05 (95% CI 2.64 to 3.46) to 4.64 (95% CI 4.18 to 5.09) times of higher risk of HBP in their late adolescence, regardless of their age, body mass index and BP level at baseline.ConclusionsSubgroups of SBP trajectories existed in Chinese boys, and are related to hypertension risk at late adolescence. Regular physical examinations could help identify those with higher risks at the beginning of pubertal growth.

scholarly journals Socioeconomic disparities in head and neck cancer survival in Germany: a causal mediation analysis using population-based cancer registry data

2021 ◽  
Author(s):  
Ahmed Bedir ◽  
Semaw Ferede Abera ◽  
Ljupcho Efremov ◽  
Lamiaa Hassan ◽  
Dirk Vordermark ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Mediation Analysis ◽  
Cancer Survival ◽  
Socioeconomic Inequality ◽  
Relative Survival ◽  
Population Based ◽  
Socioeconomic Deprivation ◽  
Stage At Diagnosis ◽  
Causal Mediation Analysis

Abstract Purpose Despite recent improvements in cancer treatment in Germany, a marked difference in cancer survival based on socioeconomic factors persists. We aim to quantify the effect of socioeconomic inequality on head and neck cancer (HNC) survival. Methods Information on 20,821 HNC patients diagnosed in 2009–2013 was routinely collected by German population-based cancer registries. Socioeconomic inequality was defined by the German Index of Socioeconomic Deprivation. The Cox proportional regression and relative survival analysis measured the survival disparity according to level of socioeconomic deprivation with respective confidence intervals (CI). A causal mediation analysis was conducted to quantify the effect of socioeconomic deprivation mediated through medical care, stage at diagnosis, and treatment on HNC survival. Results The most socioeconomically deprived patients were found to have the highest hazard of dying when compared to the most affluent (Hazard Ratio: 1.25, 95% CI 1.17–1.34). The most deprived patients also had the worst 5-year age-adjusted relative survival (50.8%, 95% CI 48.5–53.0). Our mediation analysis showed that most of the effect of deprivation on survival was mediated through differential stage at diagnosis during the first 6 months after HNC diagnosis. As follow-up time increased, medical care, stage at diagnosis, and treatment played no role in mediating the effect of deprivation on survival. Conclusion This study confirms the survival disparity between affluent and deprived HNC patients in Germany. Considering data limitations, our results suggest that, within six months after HNC diagnosis, the elimination of differences in stage at diagnosis could reduce survival inequalities.

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