Maternal health prior to pregnancy and preterm birth among urban, low income black women in Baltimore: the Baltimore Preterm Birth Study.

OBJECTIVES Black women have increased risk of preterm birth compared to white women, and overall black women are in poorer health than white women. Recent recommendations to reduce preterm birth have focused on preconception health care. We explore the associations between indicators of maternal prepregnancy health with preterm birth among a sample of black women. DESIGN The current study was prospective. SETTING Enrollment occurred in prenatal clinics in Baltimore. PARTICIPANTS Women (N=922) aged > or =18 were enrolled in the study. Data on maternal health, behaviors, and pregnancy outcome were abstracted from clinical records. MAIN OUTCOME MEASURE Logistic regression was used to evaluate associations between behavioral and health status variables with preterm birth. RESULTS In bivariate analysis, alcohol use, drug use and chronic diseases were associated with preterm birth. In the logistic regression analysis, drug use and chronic diseases were associated with preterm birth. CONCLUSIONS These results demonstrate an association between maternal health and behaviors prior to pregnancy with preterm birth among black women. Providing access to health care prior to pregnancy to address behavioral and health risks may improve pregnancy outcomes among low-income black women.