Racial disparities in preterm birth: an overview of the potential role of nutrient deficiencies

• Type of Material: Article
• Authors: Anne Dunlop, Emory University; Michael Kramer, Emory University; Carol Hogue, Emory University; Ramkumar Menon, University of Texas Medical Branch Galveston; Usha Ramakrishnan, Emory University
• Language: English
• Date: 2011-12-01
• Publisher: Wiley
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 1999 - 2017 John Wiley & Sons, Inc. All Rights Reserved
• Final Published Version (URL): http://dx.doi.org/10.1111/j.1600-0412.2011.01274.x
• Title of Journal or Parent Work: Acta Obstetricia et Gynecologica Scandinavica
• ISSN: 0001-6349
• Volume: 90
• Issue: 12
• Start Page: 1332
• End Page: 1341
• Grant/Funding Information: The series and this work are supported in part by the National Institute of Health Reproductive, Perinatal, and Pediatric Health Training grant T32 HD052460.; This article followed from a four-part seminar series on causes of racial disparities in PTB held in the autumn of 2009 at the Rollins School of Public Health, Emory University (Atlanta, GA, USA).
• Keywords: BACTERIAL VAGINOSIS; PROSPECTIVE COHORT; Obstetrics & Gynecology; NUTRITION EXAMINATION SURVEY; PREGNANCY OUTCOMES; pregnancy outcome; RANDOMIZED CONTROLLED-TRIALS; AFRICAN-AMERICAN; African-American; POLYUNSATURATED FATTY-ACIDS; micronutrients; nutritional deficiency; women's health; Science & Technology; health disparity; Life Sciences & Biomedicine; VITAMIN-D; preterm birth; IRON-DEFICIENCY; OBSTETRICS & GYNECOLOGY; FOLIC-ACID
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Objective. To give an overview of the literature for evidence of nutrient deficiencies as contributors to the disparity in preterm birth (PTB) between African-American and Caucasian women. Design. Structured literature survey. Methods. We searched MEDLINE to identify observational and experimental studies that evaluated the relation between nutrient intake and/or supplementation and PTB. For nutrients for which studies supported an association, we searched MEDLINE for studies of the prevalence of deficiency in the USA by race. Main Outcome Measures. Summarized findings on nutrients for which there is both evidence of a role in PTB and variability in t he prevalence of deficiency by race. Results. Nutrient deficiencies for which there are varying levels of evidence for an association with PTB and a greater burden among African-American compared with Caucasian women include deficiencies of iron, folic acid, zinc, vitamin D, calcium and magnesium, and imbalance of ω-3 and ω-6 polyunsaturated fatty acids. There are inadequate high-quality studies that investigate the role of nutrient deficiencies in PTB, their potential interaction with other risks, the proportion of excess risk for which they account, and whether supplementation can reduce the risk of, and racial disparities in, PTB in US populations. Conclusion. Deficiencies of several nutrients have varying levels of evidence of association with PTB and are of greater burden among African-American compared with Caucasian women. Although further research is needed, strategies that improve the nutritional status of African-American women may be a means of addressing a portion of the racial disparity in PTB. © 2011 Nordic Federation of Societies of Obstetrics and Gynecology.