Short birth-to-pregnancy intervals among African-born black women in Washington State

Abstract

Background: Short birth-to-pregnancy intervals have been associated with adverse perinatal outcomes. Racial disparities in short birth-to-pregnancy intervals and adverse perinatal outcomes are also well known. However, little is known about birth-to-pregnancy intervals among African-born black women in the US and risk factors that contribute to short birth-to-pregnancy intervals in this population.

Objectives: To investigate the risk and associated risk factors of short birth-to-pregnancy intervals among African-born black women in Washington State.

Study design: A retrospective cohort study using data from linked birth certificate and hospital discharge records for 18,984 consecutive, singleton birth pairs (1992–2013) to African-born black (n = 3312), US-born white (n = 7839), and US-born black women (n = 7833) in Washington State. Logistic regression models were used to determine adjusted odds ratios (aOR) and 95% confidence intervals (CI).

Results: Women with short birth-to-pregnancy intervals (<6 months) comprised 10.0% of African-born women, 4.3% of US-born white women, and 6.8% of US-born black women. African-born black women had 3-fold (aOR 3.44; 95%CI: 2.53–4.68) and 1.5-fold (aOR 1.49; 95%CI: 1.28–1.74) higher risk of short birth-to-pregnancy intervals compared with US-born white women and US-born black women, respectively. Among African-born black women, those born in East Africa (aOR 3.17; 95%CI: 1.92, 5.24) had higher odds of short birth-to-pregnancy intervals compared with those born in other regions of Africa. Maternal age ≥35 years old (aOR 0.59; 95%CI: 0.35, 0.98), multiparity (aOR 0.73; 95%CI: 0.54–0.98), > 12 years education (aOR 0.52; 95%CI: 0.38–0.71), and cesarean delivery in prior births (aOR 0.61; 95%CI: 0.44–0.84) were associated with lower odds of short birth-to-pregnancy intervals among African-born black women.

Conclusions: African-born black women have higher risk for short birth-to-pregnancy intervals compared with US-born white and black women. Several risk factors (age, parity, education, and prior delivery type) contribute to short birth-to-pregnancy intervals among African-born black women. Future studies may inform our understanding of factors affecting pregnancy spacing and family planning strategies among African-born black women.

Keywords:

• African-born women
• blacks
• birth-to-pregnancy interval
• health disparities
• interpregnancy interval

Acknowledgements

We would like to thank University of Washington Department of Epidemiology faculty Dr. Steve Hawes, Dr. Alyson Littman, Dr. Annette Fitzpatrick, and Bill O’Brien (data records coordinator) for their help with this study.

Disclosure statement

No competing financial interests exist.