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Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes

In 2017–2019, the March of Dimes convened a workgroup with biomedical, clinical, and epidemiologic expertise to review knowledge of the causes of the persistent Black-White disparity in preterm birth (PTB). Multiple databases were searched to identify hypothesized causes examined in peer-reviewed li...

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Autores principales: Braveman, Paula, Dominguez, Tyan Parker, Burke, Wylie, Dolan, Siobhan M., Stevenson, David K., Jackson, Fleda Mask, Collins, James W., Driscoll, Deborah A., Haley, Terinney, Acker, Julia, Shaw, Gary M., McCabe, Edward R. B., Hay, William W., Thornburg, Kent, Acevedo-Garcia, Dolores, Cordero, José F., Wise, Paul H., Legaz, Gina, Rashied-Henry, Kweli, Frost, Jordana, Verbiest, Sarah, Waddell, Lisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580804/
https://www.ncbi.nlm.nih.gov/pubmed/36303973
http://dx.doi.org/10.3389/frph.2021.684207
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author Braveman, Paula
Dominguez, Tyan Parker
Burke, Wylie
Dolan, Siobhan M.
Stevenson, David K.
Jackson, Fleda Mask
Collins, James W.
Driscoll, Deborah A.
Haley, Terinney
Acker, Julia
Shaw, Gary M.
McCabe, Edward R. B.
Hay, William W.
Thornburg, Kent
Acevedo-Garcia, Dolores
Cordero, José F.
Wise, Paul H.
Legaz, Gina
Rashied-Henry, Kweli
Frost, Jordana
Verbiest, Sarah
Waddell, Lisa
author_facet Braveman, Paula
Dominguez, Tyan Parker
Burke, Wylie
Dolan, Siobhan M.
Stevenson, David K.
Jackson, Fleda Mask
Collins, James W.
Driscoll, Deborah A.
Haley, Terinney
Acker, Julia
Shaw, Gary M.
McCabe, Edward R. B.
Hay, William W.
Thornburg, Kent
Acevedo-Garcia, Dolores
Cordero, José F.
Wise, Paul H.
Legaz, Gina
Rashied-Henry, Kweli
Frost, Jordana
Verbiest, Sarah
Waddell, Lisa
author_sort Braveman, Paula
collection PubMed
description In 2017–2019, the March of Dimes convened a workgroup with biomedical, clinical, and epidemiologic expertise to review knowledge of the causes of the persistent Black-White disparity in preterm birth (PTB). Multiple databases were searched to identify hypothesized causes examined in peer-reviewed literature, 33 hypothesized causes were reviewed for whether they plausibly affect PTB and either occur more/less frequently and/or have a larger/smaller effect size among Black women vs. White women. While definitive proof is lacking for most potential causes, most are biologically plausible. No single downstream or midstream factor explains the disparity or its social patterning, however, many likely play limited roles, e.g., while genetic factors likely contribute to PTB, they explain at most a small fraction of the disparity. Research links most hypothesized midstream causes, including socioeconomic factors and stress, with the disparity through their influence on the hypothesized downstream factors. Socioeconomic factors alone cannot explain the disparity's social patterning. Chronic stress could affect PTB through neuroendocrine and immune mechanisms leading to inflammation and immune dysfunction, stress could alter a woman's microbiota, immune response to infection, chronic disease risks, and behaviors, and trigger epigenetic changes influencing PTB risk. As an upstream factor, racism in multiple forms has repeatedly been linked with the plausible midstream/downstream factors, including socioeconomic disadvantage, stress, and toxic exposures. Racism is the only factor identified that directly or indirectly could explain the racial disparities in the plausible midstream/downstream causes and the observed social patterning. Historical and contemporary systemic racism can explain the racial disparities in socioeconomic opportunities that differentially expose African Americans to lifelong financial stress and associated health-harming conditions. Segregation places Black women in stressful surroundings and exposes them to environmental hazards. Race-based discriminatory treatment is a pervasive stressor for Black women of all socioeconomic levels, considering both incidents and the constant vigilance needed to prepare oneself for potential incidents. Racism is a highly plausible, major upstream contributor to the Black-White disparity in PTB through multiple pathways and biological mechanisms. While much is unknown, existing knowledge and core values (equity, justice) support addressing racism in efforts to eliminate the racial disparity in PTB.
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spelling pubmed-95808042022-10-26 Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes Braveman, Paula Dominguez, Tyan Parker Burke, Wylie Dolan, Siobhan M. Stevenson, David K. Jackson, Fleda Mask Collins, James W. Driscoll, Deborah A. Haley, Terinney Acker, Julia Shaw, Gary M. McCabe, Edward R. B. Hay, William W. Thornburg, Kent Acevedo-Garcia, Dolores Cordero, José F. Wise, Paul H. Legaz, Gina Rashied-Henry, Kweli Frost, Jordana Verbiest, Sarah Waddell, Lisa Front Reprod Health Reproductive Health In 2017–2019, the March of Dimes convened a workgroup with biomedical, clinical, and epidemiologic expertise to review knowledge of the causes of the persistent Black-White disparity in preterm birth (PTB). Multiple databases were searched to identify hypothesized causes examined in peer-reviewed literature, 33 hypothesized causes were reviewed for whether they plausibly affect PTB and either occur more/less frequently and/or have a larger/smaller effect size among Black women vs. White women. While definitive proof is lacking for most potential causes, most are biologically plausible. No single downstream or midstream factor explains the disparity or its social patterning, however, many likely play limited roles, e.g., while genetic factors likely contribute to PTB, they explain at most a small fraction of the disparity. Research links most hypothesized midstream causes, including socioeconomic factors and stress, with the disparity through their influence on the hypothesized downstream factors. Socioeconomic factors alone cannot explain the disparity's social patterning. Chronic stress could affect PTB through neuroendocrine and immune mechanisms leading to inflammation and immune dysfunction, stress could alter a woman's microbiota, immune response to infection, chronic disease risks, and behaviors, and trigger epigenetic changes influencing PTB risk. As an upstream factor, racism in multiple forms has repeatedly been linked with the plausible midstream/downstream factors, including socioeconomic disadvantage, stress, and toxic exposures. Racism is the only factor identified that directly or indirectly could explain the racial disparities in the plausible midstream/downstream causes and the observed social patterning. Historical and contemporary systemic racism can explain the racial disparities in socioeconomic opportunities that differentially expose African Americans to lifelong financial stress and associated health-harming conditions. Segregation places Black women in stressful surroundings and exposes them to environmental hazards. Race-based discriminatory treatment is a pervasive stressor for Black women of all socioeconomic levels, considering both incidents and the constant vigilance needed to prepare oneself for potential incidents. Racism is a highly plausible, major upstream contributor to the Black-White disparity in PTB through multiple pathways and biological mechanisms. While much is unknown, existing knowledge and core values (equity, justice) support addressing racism in efforts to eliminate the racial disparity in PTB. Frontiers Media S.A. 2021-09-02 /pmc/articles/PMC9580804/ /pubmed/36303973 http://dx.doi.org/10.3389/frph.2021.684207 Text en Copyright © 2021 Braveman, Dominguez, Burke, Dolan, Stevenson, Jackson, Collins, Driscoll, Haley, Acker, Shaw, McCabe, Hay, Thornburg, Acevedo-Garcia, Cordero, Wise, Legaz, Rashied-Henry, Frost, Verbiest and Waddell. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Reproductive Health
Braveman, Paula
Dominguez, Tyan Parker
Burke, Wylie
Dolan, Siobhan M.
Stevenson, David K.
Jackson, Fleda Mask
Collins, James W.
Driscoll, Deborah A.
Haley, Terinney
Acker, Julia
Shaw, Gary M.
McCabe, Edward R. B.
Hay, William W.
Thornburg, Kent
Acevedo-Garcia, Dolores
Cordero, José F.
Wise, Paul H.
Legaz, Gina
Rashied-Henry, Kweli
Frost, Jordana
Verbiest, Sarah
Waddell, Lisa
Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes
title Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes
title_full Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes
title_fullStr Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes
title_full_unstemmed Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes
title_short Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes
title_sort explaining the black-white disparity in preterm birth: a consensus statement from a multi-disciplinary scientific work group convened by the march of dimes
topic Reproductive Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580804/
https://www.ncbi.nlm.nih.gov/pubmed/36303973
http://dx.doi.org/10.3389/frph.2021.684207
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