How does a mother's childhood circumstances impact upon the birth outcome of her infant? Examining moderated pathways between maternal childhood well-being and birth outcomes

If a woman identifies as Non-Hispanic Black in the United States, her infant is more than twice as likely to be born preterm or of low birth weight, and nearly three times as likely to be born very low birth weight than a Non-Hispanic White infant. The cause of such inequities in birth outcomes remains elusive, however some suggest that a woman’s health across the lifespan holds the answers. If a woman’s health is compromised prior to conception, her infant’s health may suffer. Using a combination of medical chart review and in-depth structured interviewing of new mothers, this study seeks to articulate a retrospective measure of maternal childhood well-being, engaging a social determinants of health framework, to examine the pathways between a mother’s circumstances in childhood and the health of her first born infant. Stratified sampling will be employed to create two subsamples for comparison based upon the health of a women’s infant at birth (optimal or low birth weight) and the existence or absence of chronic health conditions prior to conception.  Confirmatory factor analysis will be conducted to assess cohesiveness of the defined maternal childhood well-being measure and a path analyses will be estimated to test predicted associations in the moderated model of birth outcomes. The intention of this research is to increase understanding of the etiology of inequities in birth outcomes by operationalizing largely conceptual understanding of social determinants of health and cumulative disadvantage; translating theory into tangibles to illuminate points of clinical and policy intervention and prevention.