{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:57:32Z","timestamp":1790866652126,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T00:00:00Z","timestamp":1777075200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T00:00:00Z","timestamp":1777075200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["2U54MD007597"],"award-info":[{"award-number":["2U54MD007597"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess racial and ethnic disparities in preterm delivery in the US and evaluate whether insurance type modifies these associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed National Center for Health Statistics natality data (2018\u20132024) comprising 24,918,700 singleton live births. Preterm delivery was defined as birth before 37 completed weeks of gestation. Multivariable logistic regression with robust variance was used to estimate adjusted odds ratios, predicted probabilities, and absolute risk differences across race\/ethnicity and insurance categories, adjusting for maternal sociodemographic, clinical, and obstetric factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 2,134,329 of 24,918,700 singleton live births (8.6%) were preterm during the study period, with annual rates remaining stable between 8.23% and 8.75%. In multivariable\u2010adjusted analyses, non\u2010Hispanic Black women had the highest odds of preterm delivery (adjusted odds ratio [aOR], 1.40; 95% confidence interval [CI]: 1.39\u20131.40), compared with non\u2010Hispanic White women. Racial and ethnic disparities persisted across all insurance strata; among uninsured women, non\u2010Hispanic Black women had the largest absolute risk difference relative to non\u2010Hispanic White women (5.74 percentage points; 95% CI: 5.52\u20135.96), which was attenuated but remained significant among Medicaid (2.38 percentage points; 95% CI: 2.33\u20132.43) and privately insured women (2.66 percentage points; 95% CI: 2.60\u20132.73). Insurance coverage attenuated but did not eliminate these disparities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Racial and ethnic disparities in preterm delivery persist in the US despite insurance coverage, underscoring the need for policies that address both healthcare access and structural determinants of maternal health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71038","type":"journal-article","created":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T07:34:17Z","timestamp":1777102457000},"page":"408-418","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Independent and interactive effects of race and insurance on preterm birth risk"],"prefix":"10.1002","volume":"175","author":[{"given":"Oluwasegun","family":"Akinyemi","sequence":"first","affiliation":[{"name":"The Clive O Callender Outcomes Research Center Howard University College of Medicine  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojisola","family":"Fasokun","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadeke","family":"Ogunyankin","sequence":"additional","affiliation":[{"name":"Department of Clinical and Translational Science Cook Children's Health Care System, Cook Children's Health Care System  Fort Worth Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2783-7914","authenticated-orcid":false,"given":"Ayomide Vigrey","family":"Ogunsakin","sequence":"additional","affiliation":[{"name":"The Clive O Callender Outcomes Research Center Howard University College of Medicine  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samar","family":"Khalil","sequence":"additional","affiliation":[{"name":"The Clive O Callender Outcomes Research Center Howard University College of Medicine  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Racheal","family":"Oyebade","sequence":"additional","affiliation":[{"name":"The Clive O Callender Outcomes Research Center Howard University College of Medicine  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluebubechukwu","family":"Eze","sequence":"additional","affiliation":[{"name":"The Clive O Callender Outcomes Research Center Howard University College of Medicine  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ofure","family":"Omokhodion","sequence":"additional","affiliation":[{"name":"Department of Family Medicine University of Iowa Hospital and Clinics  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Kuffour","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Central Florida  Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kakra","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Surgery Howard University College of Medicine  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoyang","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Inova Health System  Fairfax Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,25]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2016.03.045"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00878-4"},{"key":"e_1_2_11_4_1","unstructured":"World Health Organization.Preterm Birth Key Facts. Accessed 9\/10 2025.https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/preterm\u2010birth"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742-4755-10-s1-s2"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2013.204"},{"key":"e_1_2_11_7_1","volume-title":"U.S. Births Increase by 1% in 2024","author":"CDC NCfhS","year":"2025"},{"key":"e_1_2_11_8_1","volume-title":"Births: Final Data for 2023","author":"Osterman MJK","year":"2025"},{"key":"e_1_2_11_9_1","volume-title":"Valenzuela MJKO. Characteristics of Mothers by Source of Payment for the Delivery: United States","author":"Claudia P","year":"2021"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.3194"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2020.100104"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.15620\/cdc\/174587"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2022.00656"},{"key":"e_1_2_11_14_1","volume-title":"Preterm Birth","author":"CDC MIH","year":"2024"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2017.08.010"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2018-316486"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/frph.2021.684207"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2022.102923"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/01939459211041165"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.32766"},{"key":"e_1_2_11_21_1","volume-title":"5 Key Facts About Medicaid and Pregnancy","author":"Ranji AS U","year":"2025"},{"key":"e_1_2_11_22_1","volume-title":"Policy Priorities Medicaid","author":"The American College of Obstetricians and Gynecologists"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.14008"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2020.01678"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2019.7658"},{"key":"e_1_2_11_26_1","unstructured":"Services CfMM.Maternal Health Equity Data Brief: Maternal Health Outcomes in Medicaid and CHIP\u2010Covered Births.2021. Accessed 4\/1 2026.https:\/\/www.medicaid.gov\/medicaid\/data\u2010and\u2010systems\/downloads\/macbis\/2021\u2010mtrnl\u2010hlth\u2010eqty\u2010brf.pdf"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.24235"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2024.103177"},{"key":"e_1_2_11_29_1","volume-title":"Racial Disparities in Maternal and Infant Health: Current Status and Efforts to Address Them","author":"Hill AR L","year":"2022"},{"key":"e_1_2_11_30_1","unstructured":"ACOG.Health Care for Urban American Indian and Alaska Native Women. Accessed 12\/16 2025.https:\/\/www.acog.org\/clinical\/clinical\u2010guidance\/committee\u2010opinion\/articles\/2012\/01\/health\u2010care\u2010for\u2010urban\u2010american\u2010indian\u2010and\u2010alaska\u2010native\u2010women"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.12625"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.3678"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-19007-6"},{"key":"e_1_2_11_34_1","unstructured":"User guide to the 2023 Natality public use file (Centers for Disease Control and Prevention).2024."},{"key":"e_1_2_11_35_1","unstructured":"National Center for Health Statistics.Birth Edit Specifications for the 2003 Revision of the U.S. Standard Certificate of Birth.2021. 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