Aimee Afable-Munsuz, PhD¹, Paula A. Braveman, MD, MPH¹, Kristen S. Marchi, MPH², Catherine Cubbin, PhD¹, and Susan A. Egerter, PhD³. (1) Center on Social Disparities in Health, University of California, San Francisco, 500 Parnassus Avenue, MU-3E, Box 0900, San Francisco, CA 94143, (415) 502-8565, afablea@fcm.ucsf.edu, (2) Department of Family and Community Medicine, University of California, San Francisco, 500 Parnassus Avenue, MU-3 East, Box 0900, San Francisco, CA 94143-0900, (3) Family and Community Medicine, University of California, San Francisco, 500 Parnassus, MU-3E, Box 0900, San Francisco, CA 94947

Based on previous studies, it is unclear whether socioeconomic factors confound the relationship between unintended pregnancy and preterm birth (PTB). To investigate this relationship, we use three years of population-based data from a large, ethnically diverse sample of post-partum women (N=10,053) in California.

Sequential multiple regression will be used to observe the separate effects of socioeconomic factors (poverty and maternal/paternal education) and other hypothesized determinants (e.g. age, clinical risk factors, maternal behaviors, psycho-social factors) on the relationship between unintended pregnancy and PTB. The traditional measure of unintended pregnancy (mistimed and unwanted) will be used. Preliminary analysis reveals that the unadjusted odds of PTB for unintended pregnancy is 1.36 (95% CI: 1.18, 1.56). After adding all other independent variables simultaneously, the effect of unintended pregnancy becomes non-significant. The adjusted odds associated with some racial/ethnic groups, paternal education and age remain elevated and significant. In consideration of these empirical findings and that pathways may be different for women in different social groups, the analysis will be stratified by age, racial/ethnic group, and paternal education.

Stratified sequential multiple regressions should shed light on the extent to which the association between unintended pregnancy and PTB is confounded by socioeconomic factors overall, and shed light on other independent risk factors specific to the different age, socioeconomic and racial/ethnic groups. This research should inform MCH research widely by documenting whether unintended pregnancy should be considered (as widely done now) a risk factor for PTB, or as a marker for other factors associated with both.

Learning Objectives:

Participants will be able to (
• learn an analytical approach to examining hypothesized causal factors of preterm birth (and other birth outcomes) and identifying confounding relationships; and (2)better understand the causal pathways that lead to preterm birth.

Keywords: Pregnancy Outcomes,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.