An Assessment of the Effects of Risk Profiles on Preterm Delivery in African American Women

Objective: The purposes of this study are to determine the prevalence of various risk profiles among pregnant women, and to determine whether or not there are certain combinations of risks that are more strongly associated with preterm birth. Methods: Secondary data was analyzed from the Stress Pregnancy Evaluation and Community Project (SPEAC) dataset, which is a cross sectional study that was conducted in Philadelphia, PA. The study included 3419 subjects, as well as 2136 birth records. The association between multiple risk factors and preterm birth, as well as risk profiles and preterm birth were determined by using logistic regression analyses. Results: Compared with women with no risks, women with 3 risks had a greater risk of preterm birth, as the adjusted odds ratios for this category was 1. 3 8 (95% CI 0.92, 2.08). Exposure to 4 risks was associated with a higher rate of preterm rate; however the odds ratio was no longer significant after adjusting for confounding variables, OR 0.64 (95% CI 0.29-1.38). The risk profile combination of bacterial vaginosis and smoking was associated with the highest risk ofpreterm birth, with an adjusted odds ratio of 5.09 (95% CI 2.07, 12.49). In addition, the combination of stress, smoking and poverty resulted in higher rates of preterm birth, adjusted OR 2. 07 (95% CI 1. 08, 3. 98). Conclusion: There are certain combinations of risk factors that lead to higher rates of preterm birth. Prevention strategies should be directed towards the combination of risk factors, rather than individual risk factors.Master of Public Healt