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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 3

(816) Mediation of socioeconomic disparities and preterm birth by class-based discrimination and financial strain.

Friday, January 31, 2025
10:30 AM – 12:30 PM  
Objective: Various measures of low socioeconomic status (SES) have been associated with elevated preterm birth (PTB) risk. To inform intervention strategies, we sought to identify which SES markers were most predictive of PTB, and identify whether psychosocial factors mediated SES-related PTB disparities.

Study Design: Stress, Pregnancy and Health study participants completed psychosocial and demographic assessments during 2nd and 3rd trimesters. An SES “status” composite was calculated with standardized measures of occupational prestige and highest degree earned in the household; a “financial resources” composite included standardized measures of self-reported household savings relative to cost of living, household income to poverty ratio, and total savings and assets. Psychosocial mediators included lifetime, daily, and perceived class-based discrimination (CBD), and subjective financial strain (SFS). PTB was defined as delivery < 37’0 weeks gestation. Multiple regressions tested the association of PTB with the composites and their individual components, as well as potential mediators. Mediation models estimated the proportion of the association mediated by CBD and SFS. Analyses were adjusted for maternal age, race/ethnicity, and marital status.

Results: Among 599 participants, about half had the highest educational attainment and IPR. 11.5% delivered preterm. Participants with higher status had lower risk of PTB (RR: 0.72, 95%CI 0.54,0.96), whereas self-reported financial resources were not associated with PTB (Table 1). In unadjusted models, higher SFS was associated with PTB risk (RR: 1.38, 95%CI 1.13,1.68), but CBD was not. Approximately 20% of the relationship between status and PTB was mediated by SFS, though this was not statistically significant (p=0.28).

Conclusion: Status-based SES measures were significantly associated with PTB whereas financial resource-based measures were not. Our results suggest that the experience of being lower SES (i.e. social status/capital and the lived reality that these facilitate) may bear more significantly on pregnancy outcomes than self-identified monetary resources.