Explaining ethnic disparities in preterm birth in Argentina and Ecuador

ABSTRACT

Little is understood about racial/ethnic disparities in infant health in South America. We quantified the extent to which the disparity in preterm birth (PTB; <37 gestational weeks) rate between infants of Native only ancestry and those of European only ancestry in Argentina and Ecuador are explained by household socio-economic, demographic, healthcare use, and geographic location indicators. The samples included 5199 infants born between 2000 and 2011 from Argentina and 1579 infants born between 2001 and 2011 from Ecuador. An Oaxaca-Blinder type decomposition model adapted to binary outcomes was estimated to explain the disparity in PTB risk across groups of variables and specific variables. Maternal use of prenatal care services significantly explained the PTB disparity, by nearly 57% and 30% in Argentina and Ecuador, respectively. Household socio-economic status explained an additional 26% of the PTB disparity in Argentina. Differences in maternal use of prenatal care may partly explain ethnic disparities in PTB in Argentina and Ecuador. Improving access to prenatal care may reduce ethnic disparities in PTB risk in these countries.

KEYWORDS:

• Child health
• preterm birth
• racial disparities
• ethnic disparities
• health inequalities

Acknowledgements

The authors thank all health professionals and coordinators of the Latin American Collaborative Study of Congenital Anomalies (ECLAMC) for their efforts in data collection.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The study was supported by the National Institutes of Health/Fogarty International Center, USA [grant number 1R03TW008110A2].