Dunlop AL, Kramer M, Hogue CJ, Menon R, Ramakrishan U.
Acta Obstet Gynecol Scand. 2011 Sep 12.
Emory University School of Medicine, Department of Family and Preventive Medicine, Emory University Rollins School of Public Health, Women and Children's Center,Department of Epidemiology, and Emory University Rollins School of Public Health, Department of Global Health, Atlanta, Georgia, USA.
Objective. To give an overview of the literature for evidence of nutrient deficiencies as contributors to the disparity in preterm birth (PTB) between African-American and Caucasian women. Design. Structured literature survey.
Methods. We searched MEDLINE to identify observational and experimental studies that evaluated the relation between nutrient intake and/or supplementation and PTB. For nutrients for which studies supported an association, we searched MEDLINE for studies of the prevalence of deficiency in the United States by race. Main Outcome Measures. Summarized findings on nutrients for which there is both evidence of a role in PTB and variability in the prevalence of deficiency by race.
Results. Nutrient deficiencies, for which there are varying levels of evidence for an association with PTB and a greater burden among African-American compared with Caucasian women, include deficiencies of
iron, folic acid, zinc, vitamin D, calcium, and magnesium, and imbalance of omega-3 and omega-6 polyunsaturated fatty acids.
There are inadequate high-quality studies that investigate the role of nutrient deficiencies in PTB, their potential interaction with other risks, the proportion of excess risk for which they account, and whether supplementation can reduce the risk of, and racial disparities in PTB in USA populations.
Conclusion. Deficiencies of several nutrients have varying levels of evidence of association with PTB and are of greater burden among African-American compared with Caucasian women. Although further research is needed, strategies that improve the nutritional status of African-American women may be a means of addressing a portion of a racial disparity in PTB.
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