Obstetric outcomes and influencing factors of premature birth in Chinese-American women in 2022: a cohort study based on the National Vital Statistics System

This study investigates obstetric outcomes and factors influencing preterm birth among Chinese-American and American Indian or Alaskan Native women to address the gap in knowledge and inform targeted interventions. A retrospective cohort study was conducted using 2022 data from the National Vital Statistics System (NVSS), covering 50 U.S. states and the District of Columbia. The study included 40,983 Chinese-American and 35,648 AIAN women aged ≥18 years. Based on gestational age(GA), preterm birth was defined as extremely preterm birth (GA 6/7 weeks), very preterm birth (GA 280/7 to 316/7 weeks), moderately preterm birth (GA 320/7 to 336/7 weeks) and late preterm infants (GA 340/7 to 366/7 weeks). Bivariate analyses and multivariable logistic regression were used to estimate odds ratios (OR) and 95% confidence intervals (CIs) for preterm birth predictors. The preterm birth prevalence was 7.56% in Chinese-American women (5.86% late preterm) and 12.09% in AIAN women (8.98% late preterm). In both groups, preterm birth was associated with higher rates of adverse infant outcomes (low birth weight, NICU admission, surfactant therapy) and maternal complications. For Chinese-American women, significant risk factors included maternal age ≥35 years (OR = 1.23), weight gain Preterm birth disparities exist between Chinese-American and AIAN women, with shared and population-specific risk/protective factors. Routine practice should prioritize targeted monitoring for high-risk groups and promote prenatal care and optimal weight gain.