Black women have 80% higher risk of preterm birth between 32 and 33 weeks of pregnancy if a Black person who lives in their neighborhood is killed by police during the pregnancy, according to a study by researchers at UC San Francisco and UC Berkeley.
The study by scientists at the UCSF California Preterm Birth Initiative (PTBI-CA) and UC Berkeley School of Public Health, studied the records of 3.8 million pregnant women to assess whether fatal police violence occurring in their neighborhood during pregnancy was associated with extremely early, early, moderate or late preterm delivery.
"Our findings suggest that deaths due to police violence, which already differentially affect Black and Brown communities, adversely affect the health of mothers and babies during pregnancy," said first author Dana Goin, PhD, post-doctoral scholar in the UCSF Department of Obstetrics, Gynecology, and Reproductive Sciences. "In addition, we observed the strongest associations with preterm birth when the victim of the lethal violence and the mother/birth parent were both Black."
The researchers analyzed California Department of Public Health (CDPH) birth records from 2007 to 2015, using the birth parents' addresses to determine the parent's census tract of residence. They examined two different sources of police violence data, specifically CDPH death records that capture deaths due to "legal intervention" and records from the Fatal Encounters database that collects media-based accounts of police violence. They matched the police violence measures to the time range of the pregnancies, using as their control group residents of the same census tract who did not experience police violence during their pregnancy. The study published March 10, 2021, in Paediatric and Perinatal Epidemiology.
According to the analysis, neighborhoods where at least one incident of fatal police violence occurred tended to be where birth parents were Black or Latinx, had less than high school education and had public insurance, compared to all the births in California.
The World Health Organization lists preterm birth as a baby born at 37 weeks or earlier, compared to a 40-week "full-term" pregnancy, and considers birth at 32 to 33 weeks to be "moderate preterm. The Centers for Disease Control and Prevention (CDC) lists the rate of preterm births among Black women as 50% higher than the rate of preterm births among white or Latina women.
The researchers also discovered that the associations of fatal police violence with preterm birth were stronger among female infants. Since male fetuses are more sensitive to stress during pregnancy, it is plausible that male fetuses exposed to police violence may have been more likely than female fetuses to be miscarried earlier in the pregnancy, said Goin, who intends to explore this possibility further in a subsequent study.
"Our research provides evidence that policing practices that differentially harm Black people in California can also contribute to their disproportionate risk for preterm delivery," she said. "This work contributes to the evidence that additional forms of stress and hardship experienced from racism and institutional violence significantly affect their health and the health of the next generation."
Co-authors: Dana E. Goin, PhD, Brittany D. Chambers, PhD and Andrea V. Jackson, MD of UC San Francisco; Anu Manchikanti Gomez, PhD, Kriszta Farkas, MPH, Catherine Duarte, MSc, Deborah Karasek, PhD and Jennifer Ahern, PhD of UC Berkeley.
Funding: Eunice Kennedy Shriver National Institute of Child Health and Human Development, the UC Firearm Violence Research Center, the UC Berkeley Committee on Research, and the Cheri Pies Award
Disclosures: The authors have no financial ties to products in the study or potential/perceived conflicts of interest.
About the UCSF California Preterm Birth Initiative:
The UCSF California Preterm Birth Initiative (PTBI) is a research enterprise whose mission is to eliminate racial disparities in preterm birth and improve health outcomes for babies born too soon through research, partnerships and education grounded in community wisdom. PTBI conducts and funds transdisciplinary research to identify promising interventions that can turn the curve on the preterm birth epidemic and create positive change for Black and brown families. Funded by Lynne and Marc Benioff, PTBI asserts structural and interpersonal racism along with other key social determinants are important drivers of an epidemic that disproportionately affects women of color in our state, and nationally.
The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health, which serves as UCSF's primary academic medical center, includes top-ranked specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area. Learn more at ucsf.edu, or see our Fact Sheet.
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Paediatric and Perinatal Epidemiology