The Trump travel ban on Muslim-majority countries may be associated with preterm births among women, study says

The 2017 travel ban imposed by the Trump administration on seven Muslim-majority countries may be associated with an increase in preterm births among women from those countries residing in the United States, according to a new study.



a group of people standing in front of a crowd: Researchers found an increase in preterm birth rates among women from countries on the 2017 travel ban.


© Eduardo Munoz Alvarez/Getty Images
Researchers found an increase in preterm birth rates among women from countries on the 2017 travel ban.

The study, published last week in the journal Social Science and Medicine, analyzed preterm birth rates among women from countries impacted by the travel ban: Iran, Iraq, Libya, Somalia, Sudan, Syria and Yemen.

Researchers found an increase after the ban, with a preterm birth rate of 8.6% between February and September 2017. That percentage rose from 8.5% before the ban, between January 2009 and December 2016.

By comparison, US-born, non-Hispanic White women held a steady 8.6% preterm birth rate throughout the time frames.

The 0.1 percentage point increase may not seem dramatic, but it means that the odds of women from these countries having preterm births increased by 6.8%, according to lead author Goleen Samari, an assistant professor at the Columbia University Mailman School of Public Health.

“It’s a massive change when you think about a 6.8% increase,” Samurai told CNN. And because these women typically have better birth outcomes than non-Hispanic White women, Samari says, going from better to worse is significant.

Stress could be reason behind preterm births

To calculate the change, the team used a time series model to estimate the expected preterm birth numbers had the ban not been issued. They used data beginning in 2009 to see what the expected number of preterm births among women from the banned countries would be in 2017 and 2018, after the ban went into place. The team then compared the expected amount of preterm births to the actual amount, showing the elevated trend.

The researchers could not say why the policy led to a rise in preterm births. However, Samurai says that the researchers hypothesized that it was due to stress — either the initial acute stressful shock of the first order or chronic stress exposure as the ban continued to change and make headlines for its court filings or protests.

Another reason could be a decline of quality care, as some women may have avoided prenatal care because they may have felt like they were in a discriminatory environment, Samari says.

Researchers also noted some limitations in their analysis, notably that they did not use individual-level information in their analysis, like maternal facts, political ideology or gestational risk factors that may have contributed to preterm births.

The study stands out for its focus on women from the Middle East and North Africa, who tend to be overlooked as they are classified as non-Hispanic White in data, the researchers say. They add that no study had focused on the impact of a policy that is considered xenophobic and Islamophobic.

Preterm births and poor birth outcomes are “sensitive markers of temporally acute stressors from social and economic threats to

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The 2017 travel ban may be associated with preterm births among women from the targeted countries, study says

The study, published last week in the journal Social Science and Medicine, analyzed preterm birth rates among women from countries impacted by the travel ban: Iran, Iraq, Libya, Somalia, Sudan, Syria and Yemen.

Researchers found an increase after the ban, with a preterm birth rate of 8.6% between February and September 2017. That percentage rose from 8.5% before the ban, between January 2009 and December 2016.

By comparison, US-born, non-Hispanic White women held a steady 8.6% preterm birth rate throughout the time frames.

The 0.1 percentage point increase may not seem dramatic, but it means that the odds of women from these countries having preterm births increased by 6.8%, according to lead author Goleen Samari, an assistant professor at the Columbia University Mailman School of Public Health.

“It’s a massive change when you think about a 6.8% increase,” Samurai told CNN. And because these women typically have better birth outcomes than non-Hispanic White women, Samari says, going from better to worse is significant.

Stress could be reason behind preterm births

To calculate the change, the team used a time series model to estimate the expected preterm birth numbers had the ban not been issued. They used data beginning in 2009 to see what the expected number of preterm births among women from the banned countries would be in 2017 and 2018, after the ban went into place. The team then compared the expected amount of preterm births to the actual amount, showing the elevated trend.

The researchers could not say why the policy led to a rise in preterm births. However, Samurai says that the researchers hypothesized that it was due to stress — either the initial acute stressful shock of the first order or chronic stress exposure as the ban continued to change and make headlines for its court filings or protests.

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Another reason could be a decline of quality care, as some women may have avoided prenatal care because they may have felt like they were in a discriminatory environment, Samari says.

Researchers also noted some limitations in their analysis, notably that they did not use individual-level information in their analysis, like maternal facts, political ideology or gestational risk factors that may have contributed to preterm births.

The study stands out for its focus on women from the Middle East and North Africa, who tend to be overlooked as they are classified as non-Hispanic White in data, the researchers say. They add that no study had focused on the impact of a policy that is considered xenophobic and Islamophobic.

Preterm births and poor birth outcomes are “sensitive markers of temporally acute stressors from social and economic threats to war, hate crimes, and socioplitical threats,” the researchers wrote in their analysis.

Other studies have pointed to similar findings. After September 11, women with Arabic names were 34% more likely to have a low birthweight infant than before the attacks, according to a 2006 study. Another study, published in 2018, found the passage of a restrictive immigration law in Arizona
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UCF Leads Study to Identify Factors Related to Preterm Births Among Black Women

The rate of preterm births in the U.S. has been on the rise during the past six years, with a stark difference in the rate of preterm births among non-Hispanic Black women compared to non-Hispanic white women.

Preterm, or premature, birth is when a baby is born before 37 weeks of pregnancy have been completed, with the earlier the birth, the higher the risk of disability or death. According to the U.S. Centers for Disease Control and Prevention, rates for preterm births among Black women were about 50 percent higher than those for white women in 2019.

This discrepancy is why a University of Central Florida College of Nursing researcher is leading projects to identify if factors, such as social stress and paternal roles, are behind it. The work got an additional boost of nearly $460,000 recently from the U.S. National Institutes of Health to increase its scope, including examining the experiences of Black women during the COVID-19 pandemic and identifying factors related to maternal morbidity and mortality among Black women.

Carmen Giurgescu
Carmen Giurgescu, professor and associate dean for research in UCF’s College of Nursing, is leading the NIH-funded research.

“We need to know how social determinants of health influence birth outcomes among Black families,” says Carmen Giurgescu, professor and associate dean for research in the College of Nursing, who is leading the work. “The hope is that we have the foundation to develop interventions that have the potential to decrease adverse birth outcomes among Black families.”

The researchers will examine if perceived social stressors increase psychological stress and depressive symptoms resulting in greater systemic inflammation, such as higher levels of C-reactive protein, and increase the risk for preterm birth among Black women. Examples of these perceived social stressors are living in a disadvantaged neighborhood or experiencing racial discrimination.

The work is funded by two overall NIH awards. One, which was received in 2017, is for $3.5 million to study the effects of social stressors and systemic inflammation on preterm birth in Black women. The other, received in 2018, is $1.8 million to study the paternal role in adverse birth outcomes in Black families.

The recently received COVID-19 supplement of $197,000 and morbidity supplement of $260,000 from NIH will allow the researchers to explore Black women’s experiences during the COVID-19 pandemic and the factors related to maternal morbidity and mortality, respectively.

“The CDC reports that Blacks are more likely to be infected with the virus and also have a higher risk of dying from the virus,” Giurgescu says. “So, these factors may increase stress that Black women experience during this pandemic.”

Maternal morbidity and mortality were added as a focus because Black women are more likely to die during pregnancy or in the first year after birth compared to white women, Giurgescu says.

“We want to explore if any of our psychosocial measures are related to increased risk for maternal morbidity,” she says.

Giurgescu is principal investigator of the social-stressors project and is co-principal investigator of the paternal-roles project.

Chronic stress

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