Table 3.
Decomposition of the Black/White disparity in preterm birth among participants in the MIEHR study in greater Houston, Texas, 2021–2023 (n = 1,802).
| Preterm birth prevalence | % (95% CI) | - |
|---|---|---|
| Black | 23.7 (21.2, 26.2) | - |
| White | 17.1 (14.3, 19.8) | - |
| Black/White difference | 6.6 | - |
| Difference explained | ||
| Total explained | 63.0 (−11.8, 137.8) | - |
| Total unexplained | 37.0 (−52.1, 126.1) | - |
| % Contribution explained by: | ||
| Individual factors (95% CI) | Domain | |
| Sociodemographic factors | −11.9 | |
| Not married/living with a partner | 13.0 (−28.7, 54.7) | - |
| Public or no insurance | −22.8 (−78.1, 32.5) | - |
| Not employed | −2.1 (−20.4, 16.2) | - |
| Perinatal history | 36.3 | |
| Parity | 2.3 (−13.0, 17.6) | - |
| Previous pregnancy complication | 18.5 (5.7, 31.3) | - |
| HDP | 16.7 (4.6, 28.7) | - |
| Gestational diabetes | −1.2 (−4.2, 1.8) | - |
| Comorbidities and health behaviors | 11.9 | |
| Prepregnancy BMI | - | |
| Overweight | 1.1 (−5.6, 7.8) | - |
| Obese, ≥30 | −7.1 (−25.3, 11.0) | - |
| Missing | −0.5 (−3.2, 2.1) | - |
| Chronic hypertension | 16.8 (5.2, 28.4) | - |
| Antibiotics used in past month | 1.7 (−5.2, 8.5) | - |
| Chemical exposures | −12.1 | |
| Smoking in the 3 months before and/or during pregnancy | 0.6 (−2.2, 3.4) | - |
| Secondhand smoke exposure in pregnancy | 1.9 (−11.4, 15.2) | - |
| Cadmium ≥ 75th percentile | 1.1 (−1.9, 4.0) | - |
| Nickel ≥ 75th percentile | −15.6, (−28.3, −2.9) | - |
| Social factors | 6.0 | |
| Very stressful pregnancy | −4.2 (−10.1, 1.7) | - |
| Economic/logistical difficulties from COVID-19 | −0.1 (−10.1, 9.1) | - |
| EOD situations score (per 1 unit increase) | 10.3 (−14.2, 34.8) | - |
| Neighborhood characteristics | 32.8 | |
| ADI (per IQR increase) | −6.8 (−71.6, 57.9) | - |
| Low food access (per IQR increase) | 15.8 (−3.9, 35.6) | - |
| ICE <75th percentile | 19.2 (−47.8, 86.1) | - |
| Walkability index (per IQR increase) | 0.7 (−4.2, 5.6) | - |
| PM2.5 ≥ 75th percentile | 3.9 (−5.4, 13.1) | - |
ADI indicates Area Deprivation Index; ICE, Index of Concentration at the Extremes; BMI, body mass index; CI, confidence interval; IQR, interquartile range; MIEHR, Maternal and Infant Environmental Health Riskcape, PM2.5, fine particulate matter.