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Background <p>While there have been many clinical and public health efforts to improve perinatal outcomes, our understanding of how these efforts may have shaped preterm birth (PTB) racial disparities over time remains limited. The objective of this study was to describe racial disparities in PTB and its subtypes over the last four and a half decades in Massachusetts.</p> Methods <p>Using birth record data, we conducted a serial cross-sectional study of individuals who had a live birth in Massachusetts, U.S., between 1975 and 2019. We performed a trend analysis of PTB (&lt; 37 completed weeks of gestation) based on both last menstrual period (LMP) and clinical/obstetric estimates (OE), by racial group and city (Boston, Worcester). We also estimated the average proportion of PTB subtypes (medically indicated, spontaneous, unknown) by racial group.</p> Results <p>PTB rates were consistently highest among Black and lowest among Asian/Pacific Islander individuals. From 1975 to 2019, LMP-based rates increased as much as 3.52% points (Asian/Pacific Islander) and decreased as much as 1.37% points (Hispanic). From 1989 to 2019, OE-based rates increased as much as 4.08% points (Asian/Pacific Islander) and decreased as much as 1.47% points (Black). The PTB trend in Boston was comparable to the state-level trend while the temporal trend in Worcester differed somewhat. Among all racial groups, the majority of preterm births were medically indicated.</p> Conclusion <p>Racial disparities on both absolute and relative scales decreased for Black and Hispanic individuals and increased for Asian/Pacific Islander individuals, when compared with White individuals.</p>

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Trends in Singleton Preterm Birth by Race and Ethnicity: Massachusetts 1975–2019

  • 期刊论文

  • 发表日期：

    2025年12月26日

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  • Collette N. Ncube,
  • Basil Jalaleldean,
  • Ruby Barnard-Mayers,
  • Tim A. Bruckner,
  • Daniel A. Enquobahrie

摘要

Background

While there have been many clinical and public health efforts to improve perinatal outcomes, our understanding of how these efforts may have shaped preterm birth (PTB) racial disparities over time remains limited. The objective of this study was to describe racial disparities in PTB and its subtypes over the last four and a half decades in Massachusetts.

Methods

Using birth record data, we conducted a serial cross-sectional study of individuals who had a live birth in Massachusetts, U.S., between 1975 and 2019. We performed a trend analysis of PTB (< 37 completed weeks of gestation) based on both last menstrual period (LMP) and clinical/obstetric estimates (OE), by racial group and city (Boston, Worcester). We also estimated the average proportion of PTB subtypes (medically indicated, spontaneous, unknown) by racial group.

Results

PTB rates were consistently highest among Black and lowest among Asian/Pacific Islander individuals. From 1975 to 2019, LMP-based rates increased as much as 3.52% points (Asian/Pacific Islander) and decreased as much as 1.37% points (Hispanic). From 1989 to 2019, OE-based rates increased as much as 4.08% points (Asian/Pacific Islander) and decreased as much as 1.47% points (Black). The PTB trend in Boston was comparable to the state-level trend while the temporal trend in Worcester differed somewhat. Among all racial groups, the majority of preterm births were medically indicated.

Conclusion

Racial disparities on both absolute and relative scales decreased for Black and Hispanic individuals and increased for Asian/Pacific Islander individuals, when compared with White individuals.