Variations in low birth weight and preterm delivery among blacks in relation to ancestry and nativity: New York City, 1998-2002

University of North Carolina at Chapel Hill, North Carolina, United States
PEDIATRICS (Impact Factor: 5.3). 11/2006; 118(5):e1399-405. DOI: 10.1542/peds.2006-0665
Source: PubMed

ABSTRACT Black women in the United States are more likely to give birth to preterm and low birth-weight infants than their white counterparts, but little is known about variation in birth outcomes within the black population. This study aimed to test the hypothesis that the risk of low birth weight and preterm birth within the black population varies by maternal ancestry and nativity.
We conducted a retrospective cohort study using New York City birth records. All of the recorded live births to black women occurring in New York City between January 1, 1998, and December 31, 2002 (N = 168,039), were divided into the following self-reported ancestry groups: African, American, Asian, Cuban, European, Puerto Rican, South and Central American (excluding Brazilian), and West Indian and Brazilian. To estimate adjusted risk ratios for low birth weight (weight at birth <2500 g) and preterm birth (gestational age at delivery <37 weeks, based on clinical estimate), we ran 3 models for each outcome, using negative binomial regression and Poisson regression with robust SE estimation. All of the models used blacks reporting American ancestry as the reference group. The first model included ancestry as the primary exposure variable along with covariates that included maternal age, parity, smoking, and education, as well as paternal education and race. Nativity (US- or foreign-born) was included in the second model, and terms representing interaction effects between ancestry and nativity were included in the third model.
There was substantial variation in risks of preterm birth and low birth weight among the black subgroups, with all of the groups having lower risks than the American black reference group, even after adjusting for maternal risk factors and other covariates. Risk ratios for low birth weight ranged from 0.55 among South/Central Americans to 0.91 among Cubans; risk ratios for preterm birth showed a similar pattern. Nativity was also associated with low birth weight and preterm birth; births to foreign-born women were less likely to be preterm or low birth weight than births to US-born women. Furthermore, nativity effects varied by ancestry group, with foreign-born status inversely associated with poor birth outcomes among South/Central Americans but not among West Indians/Brazilians.
Important health differences may be masked in studies that treat black women in America as a homogeneous group and do not take ethnic variation and nativity into account.

Download full-text


Available from: David L Howard, Feb 17, 2014
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Lead poisoning is a serious but preventable childhood disease, caused by exposure to lead, which is found primarily in paint, soil, and household dust. Children come in contact with these sources of lead during normal indoor and outdoor play. Lead is especially dangerous to children under 7 years of age because this is a critical phase in the development of their neurological system. The implications of lead poisoning are vast, as the neurological damage it causes can lead to such problems as learning disabilities and emotional disturbances. Lead poisoning can damage a young child’s developing brain and nervous system, leading to reduced IQ and behavioral disabilities. Consequently, lead poisoning is associated with poor school performance and delinquent behavior.
    12/2010: pages 103-111;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background We examined the influence of race/ethnicity on appointment attendance, maternal psychiatric and medical diagnoses, and birth outcomes within a diverse, low income, high-risk pregnant population to determine whether birth outcome disparities would be lessened in a sample with high biopsychosocial risk across all groups. Methods Data were retrospectively obtained on all women scheduled for appointments in the San Francisco General Hospital High-Risk Obstetrics clinic during a 3-month period. General linear model and logistic regression procedures were used to examine the associations of race/ethnicity with maternal characteristics, clinic attendance, and birth outcomes. Results Our sample included 202 maternal–infant pairs (Hispanic, 57 %; Black, 16 %; Asian, 15 %; and White, 12 %). Racial/ethnic differences were seen in language (p p p = 0.005), appointment attendance (p p = 0.005), psychiatric diagnosis (p = 0.02), illicit drug use (p p p = 0.03). By contrast, Black maternal race/ethnicity was associated with earlier gestational age at birth (p = 0.004) and lower birth weight (p Conclusions Within a diverse maternal population of high biopsychosocial risk, racial/ethnic disparities in birth outcomes persist. These disparities have implications for infant health trajectory throughout the lifecourse and for intervention implementation in high-risk groups.
    03/2014; 1(1):12-20. DOI:10.1007/s40615-013-0002-2
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The acculturation effect of immigrant women on birth outcomes varies by race. We examined birth outcomes of three groups of births for the period 1995-2004, USA births to the USA-born Korean mothers, USA births to the non-USA-born Korean mothers, and births in Korea. In singleton USA births to both Korean parents, average birth weight was 3,294 g for the USA-born Korean mothers and 3,323 g for the non-USA-born Korean mothers. However, this difference was not significant, once controlled for other maternal sociodemographic, obstetric and medical factors. Low birth weight and prematurity prevalence were not different by maternal nativity between these two singleton groups. Average birth weight of all births including multiplets in Korea was 3,270 g, compared to 3,297 g for all USA-born infants including multiplets and births either to both or one Korean parents. This difference might have reflected a significantly lower educational attainment of mothers in Korea compared to Korean mothers in the USA. Low birth weight rate was consistently lower in infants born in Korea compared to the USA-born, but this difference became less, 4.2% and 4.6% respectively by 2004. These observations suggest that in the USA acculturation effect of Korean immigrants on birth outcomes is negligible.
    Journal of Korean medical science 09/2010; 25(9):1343-51. DOI:10.3346/jkms.2010.25.9.1343 · 1.25 Impact Factor