Odds of preterm birth in American Indian/Alaska Native population rose during pandemic
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Key takeaways :
- Odds of preterm birth increased in Native American/Alaska Native population in recent years.
- Causes of increased preterm birth in this population are not fully understood and warrant further investigation.
BALTIMORE — The odds of preterm birth in the American Indian/Alaska Native population in the central New York region rose significantly during the COVID-19 pandemic, researchers reported at the ACOG Annual Clinical & Scientific Meeting.
A team of researchers at State University of New York (SUNY) Upstate Medical University in Syracuse conducted a study to evaluate changes in preterm birth before and after the start of the COVID-19 pandemic among the American Indian/Alaska Native population in central New York compared with other race and ethnicity groups.
“There is a fair amount of research showing that American Indian/Alaska Native populations have an increased risk for preterm birth compared with non-Hispanic white populations,” Nicholas Baranco, MD, a third-year maternal/fetal medicine fellow at SUNY Upstate Medical University, told Healio. “However, there’s not a lot of literature regarding Native American/Alaska Native populations in general. The population in the central New York region is relatively small; it’s about 1.5% of our total population of births.”
The researchers identified 178,420 singleton births in this region from 2012 to 2022 using the New York State Perinatal Data System; 21.4% of births occurred during the COVID-19 pandemic. They then compared the rate of preterm birth among patients who self-identified as non-Hispanic white, non-Hispanic Black, American Indian/Alaska Native or other before March 2020 and from March 2020 to June 2022.
“We saw a fairly large increase in the odds of preterm, early preterm and very early preterm birth in our local Native American/Alaska Native population, while we didn’t see similar increases in other race and ethnicity groups,” Baranco told Healio.
According to the results, the odds of preterm birth before 37 weeks’ gestation increased in each race and ethnicity group over time:
- American Indian/Alaska Native: 9.8% before March 2020 to 13.4% after March 2020 (OR = 1.42);
- non-Hispanic Black: 11.8% to 13% (OR = 1.12);
- non-Hispanic white: 8.2% to 9% (OR = 1.11); and
- other: 9.1% to 10.2% (OR = 1.13).
The odds of early preterm birth before 34 weeks’ gestation and very preterm birth before 28 weeks increased only in the American Indian/Alaska Native population during the study period, from 2.8% to 4.8% (OR = 1.71) and from 0.5% to 1.7% (OR = 3.34), respectively.
The findings remained significant after adjustment for risk factors that changed during the COVID-19 pandemic, including prepregnancy BMI, diabetes, maternal age and smoking, according to the researchers.
“We did not expect to find any statistically significant difference, especially at the very early preterm birth level,” Baranco told Healio in a discussion of the results.
The researchers concluded that the causes of increased preterm birth in the American Indian/Alaska Native population are not fully understood and warrant further investigation. Baranco said follow-up will continue.
“Physicians should definitely have an awareness that Native American/Alaska Native populations have a higher risk of adverse health outcomes, including premature birth. This is a highly varied community that is difficult to study because of the relatively low numbers and diverse life experiences in different geographic regions; even within one area of one U.S. state, the experience in one tribal nation can be very different than in another,” Baranco told Healio. “Direct engagement with patients in these communities is likely going to be the best way to figure out what that community specifically needs.”