Abstract 11530: Cardiovascular Risk Profile and Preterm Birth by Maternal Nativity in Racially Diverse, Urban, Low Income Women in the United States

Abstract

Introduction: Preterm Birth (PTB) is an independent risk factor for future cardiovascular disease (CVD). Nativity-related disparities in CVD risk profile and risk of PTB have been shown among non-Hispanic Black (NHB) women; however, studies exploring these disparities among women of other races are limited. We hypothesized that foreign-born NHB, White, and Hispanic women will have better CVD risk profile and lower risk of PTB compared to their US-born counterparts. Methods: We utilized data from 6096 women with mean age 27.5(±6.3) years in the Boston Birth Cohort who self-identified as NHB (2699), White (997), or Hispanic (2400). We examined differences in sociodemographic characteristics and CVD risk factors such as smoking, obesity, and hypertension by nativity status. Using multivariable logistic regression models, we examined the association of nativity and length of U.S. residence with PTB by race. Results: Of the total sample, 27.2% delivered preterm (29.1%, 29.8%, and 24.1% among NHB, White, and Hispanic women, respectively). Compared to foreign-born women, US-born women in each of the three racial groups were younger and more likely to be obese, single, smoke in pregnancy, and report severe stress. After adjusting for sociodemographic characteristics and CVD risk factors, foreign-born NHB women had lower odds of PTB compared to U.S-born NHB women (adjusted odds ratio, aOR: 0.79; 95%CI: 0.65-0.97). Similarly, foreign-born Hispanic women had lower odds of PTB compared to U.S-born Hispanic women (aOR: 0.72; 95%CI: 0.56-0.93). In all 3 racial groups, shorter (<10 years), but not longer (≥10 years) length of U.S. residence was associated with lower odds of PTB. (Figure) Conclusions: US-born women in all three racial groups had a higher prevalence of CVD risk factors including smoking, obesity, and stress, compared to foreign-born women. The “foreign-born advantage” which is protective of PTB was not observed among foreign-born women with ≥10 years of U.S. stay.