Cande V Ananth1, Shiliang Liu, Wendy L Kinzler, Michael S Kramer. 1. Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08901-1977, USA. cande.ananth@umdnj.edu
Abstract
OBJECTIVES: We examined age, period, and cohort (APC) effects on temporal trends in stillbirths among Black and White women in the United States. METHODS: We conducted a cohort study of Black and White women who delivered a singleton live-born or stillborn infant during 1981 through 2000. We analyzed stillbirth rates at 20 or more weeks of gestation within 7 age groups, 4 periods, and 10 "central" birth cohorts after adjusting for confounders. RESULTS: In both racial groups, women younger than 20 years or 35 years or older were at increased risk of stillbirth; risks decreased over successive periods in all age groups. Birth cohort had no impact on stillbirth trends among Blacks and only a small, nonsignificant effect among Whites. Analyses of various APC combinations showed that Blacks were at a 1.2- to 2.9-fold increased risk for stillbirth relative to Whites. Attributable fractions for stillbirth because of age, period, and cohort effects were 16.5%, 24.9%, and 0.1%, respectively, among Black women and 14.5%, 36.2%, and 2.1%, respectively, among White women. CONCLUSIONS: Strong effects of age and period were observed in stillbirth trends, but these factors do not explain the persistent stillbirth disparity between Black and White women.
OBJECTIVES: We examined age, period, and cohort (APC) effects on temporal trends in stillbirths among Black and White women in the United States. METHODS: We conducted a cohort study of Black and White women who delivered a singleton live-born or stillborn infant during 1981 through 2000. We analyzed stillbirth rates at 20 or more weeks of gestation within 7 age groups, 4 periods, and 10 "central" birth cohorts after adjusting for confounders. RESULTS: In both racial groups, women younger than 20 years or 35 years or older were at increased risk of stillbirth; risks decreased over successive periods in all age groups. Birth cohort had no impact on stillbirth trends among Blacks and only a small, nonsignificant effect among Whites. Analyses of various APC combinations showed that Blacks were at a 1.2- to 2.9-fold increased risk for stillbirth relative to Whites. Attributable fractions for stillbirth because of age, period, and cohort effects were 16.5%, 24.9%, and 0.1%, respectively, among Black women and 14.5%, 36.2%, and 2.1%, respectively, among White women. CONCLUSIONS: Strong effects of age and period were observed in stillbirth trends, but these factors do not explain the persistent stillbirth disparity between Black and White women.
Authors: K Demissie; G G Rhoads; C V Ananth; G R Alexander; M S Kramer; M D Kogan; K S Joseph Journal: Am J Epidemiol Date: 2001-08-15 Impact factor: 4.897
Authors: I Martinelli; E Taioli; I Cetin; A Marinoni; S Gerosa; M V Villa; M Bozzo; P M Mannucci Journal: N Engl J Med Date: 2000-10-05 Impact factor: 91.245
Authors: Robert M Silver; Michael W Varner; Uma Reddy; Robert Goldenberg; Halit Pinar; Deborah Conway; Radek Bukowski; Marshall Carpenter; Carol Hogue; Marian Willinger; Donald Dudley; George Saade; Barbara Stoll Journal: Am J Obstet Gynecol Date: 2007-05 Impact factor: 8.661