Impact of maternal education across two generations on infant birthweight and gestation

There is a growing body of research that demonstrates the importance of contextual factors occurring throughout a woman’s life course on her reproductive outcomes.

We created a  multi-generation dataset by linking 2005-2009 resident live birth data to 1960-1997 resident live birth data in Virginia. Maternal information from the recent birth cohort was matched to infant information in the historic birth file using various combinations of mother’s birth date and first, middle, and maiden names. The final analysis dataset included 69,702 first-born singleton infants linked to their mothers own birth certificate.

In the crude analysis, both maternal and paternal educational level in the current and previous generation were associated with similarly increased odds of having an infant born small for gestational age (SGA). In the adjusted model, the strongest predictors of SGA from the current birth were maternal education <12 years (OR= 1.4; 95%CI:1.3, 1.5), father not named (OR= 1.6; 95%CI:1.5, 1.7), and father education <12 years (OR= 1.3; 95%CI:1.2, 1.5). Adjusted SGA predictors from the mother’s own birth certificate included having no father named (OR= 1.6; 95%CI:1.4, 1.7) and paternal education <12 years (OR= 1.2; 95%CI:1.1, 1.3). SGA rates were significantly lower among women who achieved higher levels of education than their mothers.

It is clear that public health programs and policymakers need to incorporate a life course perspective into their efforts in order to fully address the prevention of adverse birth outcomes. Investments in education have the potential for both short and long term payoffs in regarding reproductive outcomes.