Impact of combined maternal alcohol and tobacco use on low birth weight in singleton pregnancies: A population based study in the U.S., 2003

The incidence of Low Birth Weight (LBW) in African-American women has consistently been almost twice that of White women. Objective: The objective was to determine the risk for LBW relative to combined maternal alcohol and tobacco use, and to explore their role in contributing to the Black-White disparity within the theoretical framework of the weathering hypothesis. Methods: A population-based secondary analysis of singleton births born to US –born Black and White women reported in the NCHS Natality file. Questions: (1) What was the incidence and relative risk for LBW in relation to combined maternal alcohol and tobacco use? (2) Did LBW increase with the advancing maternal age of the Black woman? (3) Were there any similarities in maternal age, highest educational attainment by the mother, or population of the place of maternal residence within the Black and White LBW groups who reported the highest incidence of tobacco and/or alcohol use? Analysis: Logistic regression was used to calculate the relative risk of the investigational variable (LBW) while controlling for race, maternal age, tobacco and alcohol use, education, and place of residence. Results: Both races showed a trend of an increased incidence of LBW with tobacco use and increasing alcoholic consumption. Black non-Hispanic women who were tobacco and alcohol users were 3.2 times more likely to have a LBW neonate and White non-Hispanic women were 2.9 times more likely to have a LBW neonate than non-users. The rate in the Black women was 2.2 times more than the White women.