Association of participation in a supplemental nutrition program with stillbirth by race, ethnicity, and maternal characteristics

Meghan Angley, Vanessa R. Thorsten, Carolyn Drews-Botsch, Donald J. Dudley, Robert L. Goldenberg, Robert M. Silver, Barbara J. Stoll, Halit Pinar, Carol J.R. Hogue

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) has been associated with lower risk of stillbirth. We hypothesized that such an association would differ by race/ethnicity because of factors associated with WIC participation that confound the association. Methods: We conducted a secondary analysis of the Stillbirth Collaborative Research Network's population-based case-control study of stillbirths and live-born controls, enrolled at delivery between March 2006 and September 2008. Weighting accounted for study design and differential consent. Five nested models using multivariable logistic regression examined whether the WIC participation/stillbirth associations were attenuated after sequential adjustment for sociodemographic, health, healthcare, socioeconomic, and behavioral factors. Models also included an interaction term for race/ethnicity x WIC. Results: In the final model, WIC participation was associated with lower adjusted odds (aOR) of stillbirth among non-Hispanic Black women (aOR: 0.34; 95% CI 0.16, 0.72) but not among non-Hispanic White (aOR: 1.69; 95% CI: 0.89, 3.20) or Hispanic women (aOR: 0.91; 95% CI 0.52, 1.52). Conclusions: Contrary to our hypotheses, control for potential confounding factors did not explain disparate findings by race/ethnicity. Rather, WIC may be most beneficial to women with the greatest risk factors for stillbirth. WIC-eligible, higher-risk women who do not participate may be missing the potential health associated benefits afforded by WIC.

Original languageEnglish (US)
Article number306
JournalBMC Pregnancy and Childbirth
Issue number1
StatePublished - Jul 24 2018


  • Racial disparities
  • Stillbirth
  • WIC

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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