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CONFERENCE PROCEEDING
The influence of structural racism and discrimination on preterm birth: A meta-analysis of studies among Black women in the United States
1
Marquette University, College of Nursing- Midwifery Program, Milwaukee- Wi, United States
2
Aurora Healthcare, Midwifery, Milwaukee- WI, United States
3
University of Illinosis- Chicago, School of Public Health, Chicago- IL-, United States
4
Advocate Aurora Healthcare, Resarch Institute, Milwaukee- WI, United States
5
University of San Francisco, Psychology- Risk Analytics, SanFrancisco- CA, United States
6
University of California Merced Health Science Research Institute, Department of Public Health, Merced- CA, United States
7
University of Vermont College of Medicine, Department of Obstetrics- Gynecology and Reproductive Sciences, Berlington- VT, United States
Eur J Midwifery 2026;10(Supplement 1):A534
ABSTRACT
BACKGROUND:
Black birthing people in the United States experience a significantly higher rate of preterm birth (PTB) compared to White birthing people (14% vs 9%). Racism exists in three forms: internalized, interpersonal, and structural.
OBJECTIVES:
The purpose of this study was to examine the association between structural racism and PTB among Black birthing people, by racism metric, and to measure the effect of structural racism and discrimination on PTB.
METHODS:
Six databases were searched for the racism terms (e.g., residential racial segregation), measurement terms (e.g., neighborhood composition) and PTB terms. Sixty studies met the inclusion criteria (published in English, and measured association between racism and premature birth (< 37 weeks gestation) and were meta-analyzed. Heterogeneity (I-square statistics) and Odds ratios (ORs) were calculated using a random effects model. Studies with low-risk of bias were divided into sub-groups for further analysis.
RESULTS:
Racism was associated with a 7-15% increased risk of PTB [OR 1.11, 95% CI 1.07-1.15] analyzing all 60 studies and a 7-26% increased risk of PTB [OR 1.16, 95% CI 1.07-1.26] in the 14 low-risk of bias studies. Racial segregation was not associated with PTB [OR 1.05, 95% CI 0.98-1.13]. Structural measures [OR 1.23, 95% CI 1.07-1.42) and area deprivation [OR 1.40, 95% CI 1.11-1.77) were significantly associated with PTB.
CONCLUSIONS:
Our findings demonstrated that structural racism and experiences of racial discrimination increased the risk of PTB among Black birthing people, with higher odds among structural racism measures, such as area deprivation. This analysis was limited by the variety of metrics, levels, and dimensions of racism.
KEY MESSAGE:
Racism and structural discrimination should be evaluated in future studies of PTB. Researchers and clinicians must continue to develop multifactorial assessments and interventions to mitigate the harmful effects of racism and discrimination. Legislation that protects access to care is an example of a strategy to address structural racism. Poster session 1 (Group A)
Black birthing people in the United States experience a significantly higher rate of preterm birth (PTB) compared to White birthing people (14% vs 9%). Racism exists in three forms: internalized, interpersonal, and structural.
OBJECTIVES:
The purpose of this study was to examine the association between structural racism and PTB among Black birthing people, by racism metric, and to measure the effect of structural racism and discrimination on PTB.
METHODS:
Six databases were searched for the racism terms (e.g., residential racial segregation), measurement terms (e.g., neighborhood composition) and PTB terms. Sixty studies met the inclusion criteria (published in English, and measured association between racism and premature birth (< 37 weeks gestation) and were meta-analyzed. Heterogeneity (I-square statistics) and Odds ratios (ORs) were calculated using a random effects model. Studies with low-risk of bias were divided into sub-groups for further analysis.
RESULTS:
Racism was associated with a 7-15% increased risk of PTB [OR 1.11, 95% CI 1.07-1.15] analyzing all 60 studies and a 7-26% increased risk of PTB [OR 1.16, 95% CI 1.07-1.26] in the 14 low-risk of bias studies. Racial segregation was not associated with PTB [OR 1.05, 95% CI 0.98-1.13]. Structural measures [OR 1.23, 95% CI 1.07-1.42) and area deprivation [OR 1.40, 95% CI 1.11-1.77) were significantly associated with PTB.
CONCLUSIONS:
Our findings demonstrated that structural racism and experiences of racial discrimination increased the risk of PTB among Black birthing people, with higher odds among structural racism measures, such as area deprivation. This analysis was limited by the variety of metrics, levels, and dimensions of racism.
KEY MESSAGE:
Racism and structural discrimination should be evaluated in future studies of PTB. Researchers and clinicians must continue to develop multifactorial assessments and interventions to mitigate the harmful effects of racism and discrimination. Legislation that protects access to care is an example of a strategy to address structural racism. Poster session 1 (Group A)
| eISSN: | 2585-2906 |
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