Association between financial life event stressors and risk of low birth weight among African Americans and Whites: An analysis of Los Angeles Mommy and Baby (LAMB) surveys

Background:

We examined the association between financial life events stressors during pregnancy and low birth weight (LBW) among African Americans and Whites, while systematically controlling for potential confounders including individual characteristics and city-level variations and clustering.

Methods:

We analyzed data from 4970 women with singleton births from the 2007 and 2010 Los Angeles Mommy and Baby Surveys. Having experienced financial stressors was defined as having experienced at least one of the following life events during pregnancy: lost job, husband lost job, and had a lot of bills she could not pay. Multilevel logistic regression was used to assess the association between financial stressors and LBW among African Americans and Whites. Potential confounders included were:  city-level economic hardship index, maternal demographics, pre-pregnancy conditions, insurance, behavioral risk factors and social support.

Results:

Significantly higher proportion of African Americans experienced one or more financial stressors during their pregnancy, compared to Whites (p<0.001). The association between financial stressors and LBW was significantly different between African Americans and Whites (P for interaction=0.033). Experience of financial stressors during pregnancy was significantly associated with LBW among African Americans (adjusted Odds Ratio=1.49; 95% Confident Interval=1.01, 2.20) but not whites.

Conclusions:

The three financial life event stressors examined in this study were more likely to impact African Americans than Whites. Differential impact of financial stressors during pregnancy may contribute to racial disparities in LBW among African Americans and Whites. Financial stress during pregnancy is an important area for public health to address to improve birth outcomes among African Americans.