Association of participation in a supplemental nutrition program with stillbirth by race, ethnicity, and maternal characteristics
Abstract Background Participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) has been associated with lower risk of stillbirth. We hypothesized that such an association would differ by race/ethnicity because of factors associated with WIC participation that c...
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| Format: | Article |
| Language: | English |
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BMC
2018-07-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12884-018-1920-0 |
| _version_ | 1818287496313700352 |
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| author | Meghan Angley Vanessa R. Thorsten Carolyn Drews-Botsch Donald J. Dudley Robert L. Goldenberg Robert M. Silver Barbara J. Stoll Halit Pinar Carol J. R. Hogue |
| author_facet | Meghan Angley Vanessa R. Thorsten Carolyn Drews-Botsch Donald J. Dudley Robert L. Goldenberg Robert M. Silver Barbara J. Stoll Halit Pinar Carol J. R. Hogue |
| author_sort | Meghan Angley |
| collection | DOAJ |
| description | Abstract Background Participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) has been associated with lower risk of stillbirth. We hypothesized that such an association would differ by race/ethnicity because of factors associated with WIC participation that confound the association. Methods We conducted a secondary analysis of the Stillbirth Collaborative Research Network’s population-based case-control study of stillbirths and live-born controls, enrolled at delivery between March 2006 and September 2008. Weighting accounted for study design and differential consent. Five nested models using multivariable logistic regression examined whether the WIC participation/stillbirth associations were attenuated after sequential adjustment for sociodemographic, health, healthcare, socioeconomic, and behavioral factors. Models also included an interaction term for race/ethnicity x WIC. Results In the final model, WIC participation was associated with lower adjusted odds (aOR) of stillbirth among non-Hispanic Black women (aOR: 0.34; 95% CI 0.16, 0.72) but not among non-Hispanic White (aOR: 1.69; 95% CI: 0.89, 3.20) or Hispanic women (aOR: 0.91; 95% CI 0.52, 1.52). Conclusions Contrary to our hypotheses, control for potential confounding factors did not explain disparate findings by race/ethnicity. Rather, WIC may be most beneficial to women with the greatest risk factors for stillbirth. WIC-eligible, higher-risk women who do not participate may be missing the potential health associated benefits afforded by WIC. |
| first_indexed | 2024-12-13T01:41:25Z |
| format | Article |
| id | doaj.art-f826345c6232488cb915b1fb68b172eb |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-13T01:41:25Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-f826345c6232488cb915b1fb68b172eb2022-12-22T00:03:44ZengBMCBMC Pregnancy and Childbirth1471-23932018-07-011811810.1186/s12884-018-1920-0Association of participation in a supplemental nutrition program with stillbirth by race, ethnicity, and maternal characteristicsMeghan Angley0Vanessa R. Thorsten1Carolyn Drews-Botsch2Donald J. Dudley3Robert L. Goldenberg4Robert M. Silver5Barbara J. Stoll6Halit Pinar7Carol J. R. Hogue8Department of Epidemiology, Rollins School of Public Health, Emory UniversityBiostatistics and Epidemiology Division, RTI InternationalDepartment of Epidemiology, Rollins School of Public Health, Emory UniversityDepartment of Obstetrics and Gynecology, University of Virginia School of MedicineDepartment of Obstetrics and Gynecology, Columbia University Medical CenterDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, School of Medicine, University of UtahMcGovern Medical School, University of Texas Health Science CenterThe Warren Alpert School of Medicine, Brown UniversityDepartment of Epidemiology, Rollins School of Public Health, Emory UniversityAbstract Background Participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) has been associated with lower risk of stillbirth. We hypothesized that such an association would differ by race/ethnicity because of factors associated with WIC participation that confound the association. Methods We conducted a secondary analysis of the Stillbirth Collaborative Research Network’s population-based case-control study of stillbirths and live-born controls, enrolled at delivery between March 2006 and September 2008. Weighting accounted for study design and differential consent. Five nested models using multivariable logistic regression examined whether the WIC participation/stillbirth associations were attenuated after sequential adjustment for sociodemographic, health, healthcare, socioeconomic, and behavioral factors. Models also included an interaction term for race/ethnicity x WIC. Results In the final model, WIC participation was associated with lower adjusted odds (aOR) of stillbirth among non-Hispanic Black women (aOR: 0.34; 95% CI 0.16, 0.72) but not among non-Hispanic White (aOR: 1.69; 95% CI: 0.89, 3.20) or Hispanic women (aOR: 0.91; 95% CI 0.52, 1.52). Conclusions Contrary to our hypotheses, control for potential confounding factors did not explain disparate findings by race/ethnicity. Rather, WIC may be most beneficial to women with the greatest risk factors for stillbirth. WIC-eligible, higher-risk women who do not participate may be missing the potential health associated benefits afforded by WIC.http://link.springer.com/article/10.1186/s12884-018-1920-0StillbirthRacial disparitiesWIC |
| spellingShingle | Meghan Angley Vanessa R. Thorsten Carolyn Drews-Botsch Donald J. Dudley Robert L. Goldenberg Robert M. Silver Barbara J. Stoll Halit Pinar Carol J. R. Hogue Association of participation in a supplemental nutrition program with stillbirth by race, ethnicity, and maternal characteristics BMC Pregnancy and Childbirth Stillbirth Racial disparities WIC |
| title | Association of participation in a supplemental nutrition program with stillbirth by race, ethnicity, and maternal characteristics |
| title_full | Association of participation in a supplemental nutrition program with stillbirth by race, ethnicity, and maternal characteristics |
| title_fullStr | Association of participation in a supplemental nutrition program with stillbirth by race, ethnicity, and maternal characteristics |
| title_full_unstemmed | Association of participation in a supplemental nutrition program with stillbirth by race, ethnicity, and maternal characteristics |
| title_short | Association of participation in a supplemental nutrition program with stillbirth by race, ethnicity, and maternal characteristics |
| title_sort | association of participation in a supplemental nutrition program with stillbirth by race ethnicity and maternal characteristics |
| topic | Stillbirth Racial disparities WIC |
| url | http://link.springer.com/article/10.1186/s12884-018-1920-0 |
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