Do Birth Outcomes of Parents With Discordant vs. Concordant Self-Reported Race/Ethnicity Differ When Accounting for Social Determinants of Health?

Author Type(s)

Faculty, Resident/Fellow

Document Type

Abstract

Publication Date

2022

DOI

10.1136/jim-2022-ERM.249

Journal Title

Journal of Investigative Medicine

Department

Pediatrics

Abstract

Purpose of Study Differences in maternal race, social determinants of health and adverse life events are all linked to disparities in birth outcomes. There is a paucity of data on birth outcomes of discordant race/ethnicity parents. Our objective was to identify associations between self-reported parental race/ethnicity, socioeconomic characteristics and adverse life events with birth outcomes to parents of discordant race/ ethnicities. Methods Used This is a cross-sectional analysis (2016-2020) of survey data of parents (≥18 years) of singleton live-born infants. Outcomes including NICU admission (NICU), small for gestational age and preterm birth (PTB, <37 weeks) were obtained from birth certificate data and analyzed by selfreported parental race/ethnicity. Parents selecting White/Caucasian were categorized as White. Non-White category included any of the following: Black, Hispanic, or Other (American Indian/Alaskan native/Hawaiian/Pacific Islander/ Asian). Covariates included: adverse life events, lifestyle behaviors, high-risk pregnancy conditions, and other sociodemographic data. Summary of Results 362 mother-father dyads were analyzed and grouped as (W=White, NW=Non-White, M=Mother, F=Father): WM-NWF (9%), NWM-WF (9%), WM-WF (37%) and NWM-NWF (45%). WM-WF had higher rates of parental education, exercise, substance use and maternal adverse life events (p's<0.05). NWM-NWF parents were more likely to be foreign born, insured by Medicaid and have a high-risk pregnancy (p's<0.05). In adjusted analyses, WM-NWF had higher odds of NICU [OR 3.75 (95% CI 1.22 - 11.51)] and PTB [4.38 (95% CI 1.07 - 17.87)] compared to WM-WF. NWM-WF and NWM-NWF did not differ from WM-WF in odds of adverse birth outcomes. Conclusions Infants born to WM-NWF have higher odds of NICU & PTB compared to WM-WF. We speculate that increased stress WM-NWF dyads face may increase risk of these adverse birth outcomes. Our results suggest self-reported parental race/ethnicity should be assessed prenatally to provide additional support as needed to potentially mitigate the observed differences.

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