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Multicenter Study
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, and Eunice Kennedy Shriver National Institute of Child Health and Human Development Stillbirth Collaborative Research Network Writing Group.
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA. chogue@emory.edu
- Am. J. Epidemiol. 2013 Apr 15;177(8):755-67.
AbstractStillbirths (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.
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