An overview of racial disparities in preterm birth rates: Caused by infection or inflammatory response?

Ramkumar Menon, Anne L. Dunlop, Michael R. Kramer, Stephen J. Fortunato, Carol J. Hogue

Research output: Contribution to journalReview article

50 Scopus citations

Abstract

Infection has been hypothesized to be one of the factors associated with spontaneous preterm birth (PTB) and with the racial disparity in rates of PTB between African American and Caucasian women. However, recent findings refute the generalizability of the role of infection and inflammation. African Americans have an increased incidence of PTB in the setting of intraamniotic infection, periodontal disease, and bacterial vaginosis compared to Caucasians. Herein we report variability in infection- and inflammation-related factors based on race/ethnicity. For African American women, an imbalance in the host proinflammatory response seems to contribute to infection-associated PTB, as evidenced by a greater presence of inflammatory mediators with limited or reduced presence of immune balancing factors. This may be attributed to differences in the genetic variants associated with PTB between African Americans and Caucasians. We argue that infection may not be a cause of racial disparity but in association with other risk factors such as stress, nutritional deficiency, and differences in genetic variations in PTB, pathways and their complex interactions may produce differential inflammatory responses that may contribute to racial disparity.

Original languageEnglish (US)
Pages (from-to)1325-1331
Number of pages7
JournalActa Obstetricia et Gynecologica Scandinavica
Volume90
Issue number12
DOIs
StatePublished - Dec 2011

Keywords

  • African American
  • health disparities
  • infant health
  • infection
  • prematurity

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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