A population-based case-control study of stillbirth: The relationship of significant life events to the racial disparity for African Americans

Carol J.R. Hogue, Corette B. Parker, Marian Willinger, Jeff R. Temple, Carla M. Bann, Robert M. Silver, Donald J. Dudley, Matthew A. Koch, Donald R. Coustan, Barbara J. Stoll, Uma M. Reddy, Michael W. Varner, George R. Saade, Deborah Conway, Robert L. Goldenberg

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

Stillbirths (fetal deaths occurring at ≥20 weeks' gestation) are approximately equal in number to infant deaths in the United States and are twice as likely among non-Hispanic black births as among non-Hispanic white births. The causes of racial disparity in stillbirth remain poorly understood. A population-based case-control study conducted by the Stillbirth Collaborative Research Network in 5 US catchment areas from March 2006 to September 2008 identified characteristics associated with racial/ethnic disparity and interpersonal and environmental stressors, including a list of 13 significant life events (SLEs). The adjusted odds ratio for stillbirth among women reporting all 4 SLE factors (financial, emotional, traumatic, and partner-related) was 2.22 (95% confidence interval: 1.43, 3.46). This association was robust after additional control for the correlated variables of family income, marital status, and health insurance type. There was no interaction between race/ethnicity and other variables. Effective ameliorative interventions could have a substantial public health impact, since there is at least a 50% increased risk of stillbirth for the approximately 21% of all women and 32% of non-Hispanic black women who experience 3 or more SLE factors during the year prior to delivery.

Original languageEnglish (US)
Pages (from-to)755-767
Number of pages13
JournalAmerican journal of epidemiology
Volume177
Issue number8
DOIs
StatePublished - Apr 15 2013
Externally publishedYes

Keywords

  • African Americans
  • case-control studies
  • continental population groups
  • life change events
  • psychosocial stress
  • socioeconomic factors
  • stillbirth
  • stress

ASJC Scopus subject areas

  • Epidemiology

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    Hogue, C. J. R., Parker, C. B., Willinger, M., Temple, J. R., Bann, C. M., Silver, R. M., Dudley, D. J., Koch, M. A., Coustan, D. R., Stoll, B. J., Reddy, U. M., Varner, M. W., Saade, G. R., Conway, D., & Goldenberg, R. L. (2013). A population-based case-control study of stillbirth: The relationship of significant life events to the racial disparity for African Americans. American journal of epidemiology, 177(8), 755-767. https://doi.org/10.1093/aje/kws381