172138 Trends in maternal characteristics, low birth weight (LBW) and preterm birth (PTB) rates among U.S. non-Hispanic Black women, 1991 - 2004

Tuesday, October 28, 2008: 10:55 AM

Cynthia D. Ferre , Division of Reproductive Health, CDC, Atlanta, GA
Arden Handler, DrPH , Community Health Sciences Division, University of Illinois at Chicago, School of Public Health, Chicago, IL
Jason Hsia, PhD , Division of Reproductive Health, US Centers for Disease Control and Prevention, Atlanta, GA
Wanda Barfield, MD, MPH , Division of Reproductive Health, CDC, Atlanta, GA
James W. Collins, MD, MPH , Northwestern University, Children's Memorial Hospital, Chicago, IL
Reducing LBW and PTB rates among non-Hispanic Black (NHB) women has been a clinical and public health priority for over two decades. Simultaneously, changes in demographics, health status and care use, and social programs occurred which potentially affected this population and outcomes.

We analyzed changes in LBW, moderate LBW (MLBW), very LBW (VLBW), and PTB rates from 1991 to 2004 for U.S. singleton live births to NHB women. We conducted cross-sectional and trend analyses using Joinpoint, stratified, and binomial regression methods. In comparing variables other than outcomes between 2003 or 2004 and earlier years, analyses were restricted to States using the 1989 birth certificate revision.

We identified a change in trend in 2001. LBW rates declined from 12.15% in 1991 to 11.19% in 2001 and then increased to 11.70% in 2004. PTB trends resembled those for LBW. The LBW trend was explained by the MLBW trend: 9.60% in 1991; 8.62% in 2001; 9.10% in 2004. VLBW did not follow this pattern, minimally increasing from 1991-2001 and then remaining relatively stable through 2004. In adjusted models, the 1991-2001 MLBW decrease was explained by increases in 1st trimester prenatal care, foreign-born mothers, maternal education and weight gain and reductions in smoking. The 2001-2004 MLBW increase remained independent of changes in demographics, prenatal care, obstetric history, and obstetric interventions. The effects of education, as a marker for socioeconomic status, and of social policy changes on outcomes are explored. To achieve Healthy People 2010 goals, continued risk reduction among NHB women remains a priority.

Learning Objectives:
Describe trends from 1991 to 2004 in low birth weight outcomes for non-Hispanic Black women. Discuss the associations between changing maternal characteristics and low birth weight outcomes among non-Hispanic Black women. Articulate the limitations of using birth certificate data in studying pregancy outcomes.

Keywords: African American, Pregnancy Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I originated the study to be presented including the study idea/hypotheses, design, and methods. I conducted all of the analyses and wrote the first draft of the paper. I worked with my co-authors on revisions.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.