Maternal Micronutrient Status and Preterm Versus Term Birth for Black and White US Women

Objective. Micronutrient deficiencies are hypothesized to play a role in spontaneous preterm birth (PTB; <37 weeks of gestation) and possibly the racial disparity in rates of PTB between black and white women. Yet relatively few studies have addressed the role of micronutrient deficiencies in spontaneous PTB among black and white women in the United States. The purpose of this study was to investigate whether 25-hydroxy vitamin D (25-OH-D), folate, and omega-6/omega-3 fatty acid status are associated with spontaneous PTB among black and white women in the United States. Methods. Biospecimens and medical record data for this study were derived from a subsample of the 1547 women enrolled into the Nashville Birth Cohort during 2003-2006. We randomly selected 80 nulliparous and primiparous women for whom stored plasma samples from the delivery admission were available and analyzed the stored plasma for 25-OH-D, folate, and total omega-6/omega-3 fatty acids. We used multivariate logistic regression to assess the odds of spontaneous PTB among women with 25-OH-D <20 ng/mL, folate <5 ug/L, and omega-6/omega-3 >15. Results. An omega-6/omega-3 ratio >15 was significantly associated with spontaneous PTB for white (adjusted odds ratio [aOR] 4.25, 95% confidence interval [CI] 1.25-14.49) but not black women (aOR 1.90, 95% CI: 0.69-5.40), whereas no significant relationships were observed for folate and 25-OH-D status and PTB for black or white women. Conclusion. Maternal plasma total omega-6/omega-3 fatty acid ratio >15 at delivery was significantly associated with spontaneous PTB for white, but not black, women.