ArticleRevista de saude publica2026
Racial inequalities in preterm birth in Central-West Brazil, 2015-2024: a population-based cross-sectional study.
Article in Revista de saude publica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo examine racial inequalities in preterm birth (PTB; < 37 weeks) among White, Parda, Black, and Indigenous mothers in Brazil's Central-West region using a population-based cross-sectional design.
methodsWe analyzed 2,156,674 live births registered in Sistema de Informação sobre Nascidos Vivos (2015-2024) across Goiás, Mato Grosso, Mato Grosso do Sul, and the Federal District. Logistic regression with progressive covariate adjustment estimated odds ratios, with White mothers as the reference group; prevalence ratios from Poisson regression with robust variance, adjusted probabilities by group, and absolute risk differences were estimated as complementary measures.
resultsCrude preterm birth prevalence was 11.1% (White), 11.0% (Parda), 11.7% (Black), and 17.6% (Indigenous). In the primary sociodemographic model, Indigenous mothers had 50.4% higher odds (OR = 1.504; 95% CI 1.461-1.549), corresponding to a 28.9% attenuation of the crude OR. The adjusted probability of preterm birth was 15.9% among Indigenous versus 11.2% among White mothers (absolute difference 4.7 percentage points; prevalence ratio 1.41). In exploratory models additionally adjusting for prenatal care, parity, and marital status (n = 2,146,853), the Indigenous OR was attenuated to 1.222 (95% CI 1.186-1.259), although adjustment for prenatal visits is susceptible to reverse causation. Black mothers showed a modest crude excess (OR = 1.053) that did not persist after adjustment (full model OR = 0.973), and Parda mothers showed slightly lower odds throughout.
conclusionIndigenous mothers in the Central-West experience a substantial preterm birth inequality that is only partially attenuated by measured sociodemographic factors and is compatible with the influence of unmeasured structural and contextual determinants.
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