The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

3273.0: Monday, November 17, 2003 - 2:45 PM

Abstract #56230

Testing a fetal origins model for the racial disparity in adult reproductive outcome: A population-based study

Dyan Simon, MD1, Shilpa Vyas, MD1, Nikhil Prachand, MS2, Richard David, MD3, and James W. Collins, MD, MPH1. (1) Pediatrics/Neonatology, Northwestern University/Children's Memorial Hospital, 2300 Children's Plaza, Box 45, Chicago, IL 60614, 773-880-4142,, (2) School of Public Health, The University of Illinois at Chicago, 2121 W. Taylor Street, Room 552, Chicago, IL 60612, (3) Neonatology, Cook County Hospital, 1835 W. Harrison Street, Chicago, IL 60612

Objective. To determine the extent to which maternal low birth weight (<2500g, LBW) is a risk factor for infant intrauterine growth retardation and prematurity among whites and African-Americans.

Methods. Stratified and multivariate logistic regression analyses were performed on an Illinois transgenerational vital record dataset of infants born between 1989-1991 and their mothers between 1956-1976.

Results. In Illinois, former LBW white women (N=11,445) had greater infant SGA (wt-for-gestational age < 10th percentile) and prematurity (< 37 wks) rates than former non-LBW white women (N=192,253); RR= 1.8 (1.8-1.9) and 1.3 (1.3-1.4), respectively. Former LBW African-American women (N=8,374) also had greater rates of infant SGA and prematurity than former non-LBW African-American women (N=53,475); RR= 1.6 (1.5-1.7) and 1.4 (1.3-1.4), respectively. For both races, the maternal birth weight-infant outcome associations were consistent across maternal age, education, marital status, smoking, alcohol, and prenatal care categories. Most striking, former LBW college-educated white women (N=1,013) who received adequate prenatal care still had greater infant SGA and prematurity rates than former non-LBW white women (N=22,368) of similar low-risk status; RR=2.1 (1.5-2.7) and 1.8 (1.2-2.6), respectively. A similar trend occurred among African-Americans. Interestingly, the racial disparity in both SGA and prematurity rates persisted among infants born to former non-LBW women independent of adult risk status; adjusted OR= 2.2 (1.5-3.0) and 2.8 (2.4-3.2), respectively.

Conclusions. We conclude that maternal LBW is a stronger risk factor for infant intrauterine growth retardation than prematurity; yet, it fails to account for the African-American women’s reproductive disadvantage.

Learning Objectives:

Keywords: African American, Birth Outcomes

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Maternal and Child Health Epidemiology: Data for Programs and Policy Making

The 131st Annual Meeting (November 15-19, 2003) of APHA