Skip to main content

Advertisement

SpringerLink
Log in

One Size Does Not Fit All: An Examination of Low Birthweight Disparities Among a Diverse Set of Racial/Ethnic Groups

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

To examine disparities in low birthweight using a diverse set of racial/ethnic categories and a nationally representative sample. This research explored the degree to which sociodemographic characteristics, health care access, maternal health status, and health behaviors influence birthweight disparities among seven racial/ethnic groups. Binary logistic regression models were estimated using a nationally representative sample of singleton, normal for gestational age births from 2001 using the ECLS-B, which has an approximate sample size of 7,800 infants. The multiple variable models examine disparities in low birthweight (LBW) for seven racial/ethnic groups, including non-Hispanic white, non-Hispanic black, U.S.-born Mexican-origin Hispanic, foreign-born Mexican-origin Hispanic, other Hispanic, Native American, and Asian mothers. Race-stratified logistic regression models were also examined. In the full sample models, only non-Hispanic black mothers have a LBW disadvantage compared to non-Hispanic white mothers. Maternal WIC usage was protective against LBW in the full models. No prenatal care and adequate plus prenatal care increase the odds of LBW. In the race-stratified models, prenatal care adequacy and high maternal health risks are the only variables that influence LBW for all racial/ethnic groups. The race-stratified models highlight the different mechanism important across the racial/ethnic groups in determining LBW. Differences in the distribution of maternal sociodemographic, health care access, health status, and behavior characteristics by race/ethnicity demonstrate that a single empirical framework may distort associations with LBW for certain racial and ethnic groups. More attention must be given to the specific mechanisms linking maternal risk factors to poor birth outcomes for specific racial/ethnic groups.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. Data for this analysis were obtained by permission and approval of the Institute of Education Sciences (IES) Data Security Office of the U.S. Department of Education, National Center for Education Statistics. Due to the sensitive nature of the information contained in this data, the author has obtained a restricted data license allowing the use of this data source for the above research purpose. All protocols specified in the restricted data license agreement were followed in order to protect the confidentiality of respondents. Copies of the data are not available from the author. Interested parties should contact the IES Data Security Office at IESData.Security@ed.gov if interested in obtaining their own restricted data license for the ECLS-B.

References

  1. Markides, K. S., & Coreil, J. (1986). The health of Hispanics in the Southwestern United States—an epidemiologic paradox. Public Health Reports, 101, 253–265.

    PubMed  CAS  Google Scholar 

  2. Collins, J. W., & Shay, D. K. (1994). Prevalence of low-birth-weight among Hispanic infants with United States-born and foreign-born mothers—the effect of urban poverty. American Journal of Epidemiology, 139, 184–192.

    PubMed  Google Scholar 

  3. Abrams, B., & Guendelman, S. (1995). Nutrient intake of Mexican-American and non-Hispanic white women by reproductive status—results of 2 national studies. Journal of the American Dietetic Association, 95, 916–918. doi:10.1016/S0002-8223(95)00253-7.

    Article  PubMed  CAS  Google Scholar 

  4. Guendelman, S., & Abrams, B. (1995). Dietary-intake among Mexican-American women: Generational differences and a comparison with white non-Hispanic women. American Journal of Public Health, 85, 20–25. doi:10.2105/AJPH.85.1.20.

    Article  PubMed  CAS  Google Scholar 

  5. Acevedo-Garcia, D., Soobader, M. J., & Berkman, L. F. (2005). The differential effect of foreign-born status on low birth weight by race/ethnicity and education. Pediatrics, 115, E20–E30.

    PubMed  Google Scholar 

  6. Acevedo-Garcia, D., Soobader, M. J., & Berkman, L. F. (2007). Low birthweight among US Hispanic/Latino subgroups: The effect of maternal foreign-born status and education. Social Science and Medicine, 65, 2503–2516. doi:10.1016/j.socscimed.2007.06.033.

    Article  PubMed  Google Scholar 

  7. Weigers, M. E., & Sherraden, M. S. (2001). A critical examination of acculturation: The impact of health behaviors, social support and economic resources on birth weight among women of Mexican descent. The International Migration Review, 35, 804–839.

    Google Scholar 

  8. English, P. B., Kharrazi, M., & Guendelman, S. (1997). Pregnancy outcomes and risk factors in Mexican Americans: The effect of language use and mother’s birthplace. Ethnicity and Disease, 7, 229–240.

    PubMed  CAS  Google Scholar 

  9. Page, R. L. (2004). Positive pregnancy outcomes in Mexican immigrants: What can we learn? Journal of Obstetric, Gynecologic, and Neonatal Nursing, 33, 783–790. doi:10.1177/0884217504270595.

    Article  PubMed  Google Scholar 

  10. Goldman, N., Kimbro, R. T., Turra, C. M., & Pebley, A. R. (2006). Socioeconomic gradients in health for white and Mexican-origin populations. American Journal of Public Health, 96, 2186–2193. doi:10.2105/AJPH.2005.062752.

    Article  PubMed  Google Scholar 

  11. Becerra, J. E., Hogue, C. J. R., Atrash, H. K., & Perez, N. (1991). Infant mortality among Hispanics: A portrait of heterogeneity. Journal of the American Medical Association, 265, 217–221. doi:10.1001/jama.265.2.217.

    Article  PubMed  CAS  Google Scholar 

  12. Engel, T., Alexander, G. R., & Leland, N. L. (1995). Pregnancy outcomes of United States-born Puerto Ricans: The role of maternal nativity status. American Journal of Preventive Medicine, 11, 34–39.

    PubMed  CAS  Google Scholar 

  13. Hummer, R. A., Rogers, R. G., Amir, S. H., Forbes, D., & Frisbie, W. P. (2000). Mortality differentials among Hispanic subgroups and non-Hispanic whites. Social Science Quarterly, 81, 459–476.

    PubMed  CAS  Google Scholar 

  14. Morales, L. S., Lara, M., Kington, R. S., Valdez, R. O., & Escarce, J. J. (2002). Socioeconomic, cultural, and behavioral factors affecting Hispanic health outcomes. Journal of Health Care for the Poor and Underserved, 13, 477–503. doi:10.1177/104920802762475120.

    Article  PubMed  Google Scholar 

  15. Kleinman, J. C., Fingerhut, L. A., & Prager, K. (1991). Differences in infant mortality by race, nativity status, and other maternal characteristics. American Journal of Diseases of Children, 145, 194–199.

    PubMed  CAS  Google Scholar 

  16. Singh, G. K., & Yu, S. M. (2002). Adverse pregnancy outcomes: differences between U.S.- and foreign-born women in major U.S. racial and ethnic groups. In T. A. LaVeist (Ed.), Race, ethnicity, and health: a public health reader (pp. 265–279). San Francisco, CA: Jossey-Bass.

    Google Scholar 

  17. Ventura, S., & Taffel, S. (1985). Childbearing practices of U.S.-born and foreign-born Hispanic mothers. Public Health Reports, 100(64), 7–652.

    Google Scholar 

  18. Scribner, R., & Dwyer, J. H. (1989). Acculturation and low-birth-weight among Latinos in the Hispanic HANES. American Journal of Public Health, 79, 1263–1267. doi:10.2105/AJPH.79.9.1263.

    Article  PubMed  CAS  Google Scholar 

  19. Franzini, L., Ribble, J. C., & Keddie, A. M. (2002). Understanding the Hispanic paradox. In T. A. LaVeist (Ed.), Race, ethnicity, and health: a public health reader (pp. 280–310). San Francisco, CA: Jossey-Bass.

    Google Scholar 

  20. Gould, J. B., Madan, A., Qin, C., & Chavez, G. (2003). Perinatal outcomes in two dissimilar immigrant populations in the United States: A dual epidemiologic paradox. Pediatrics, 111, E676–E682. doi:10.1542/peds.111.6.e676.

    Article  PubMed  Google Scholar 

  21. Reichman, N. E., Hamilton, E. R., Hummer, R. A., & Padilla, Y. C. (2008). Racial and ethnic disparities in low birthweight among urban unmarried mothers. Maternal and Child Health Journal, 12, 204–215. doi:10.1007/s10995-007-0240-1.

    Article  PubMed  Google Scholar 

  22. Schoendorf, K. C., Hogue, C. J. R., Kleinman, J. C., & Rowley, D. (1992). Mortality among infants of black compared to white college educated parents. The New England Journal of Medicine, 326, 1522–1526.

    Article  PubMed  CAS  Google Scholar 

  23. Colen, C. G., Geronimus, A. T., Bound, J., & James, S. A. (2006). Maternal upward socioeconomic mobility and black-white disparities in infant birthweight. American Journal of Public Health, 96, 2032–2039. doi:10.2105/AJPH.2005.076547.

    Article  PubMed  Google Scholar 

  24. Teitler, J. O., Reichman, N. E., Nepomnyaschy, L., & Martinson, M. (2007). A cross-national comparison of racial and ethnic disparities in low birth weight in the United States and England. Pediatrics, 120, E1182–E1189. doi:10.1542/peds.2006-3526.

    Article  Google Scholar 

  25. Wang, X. B., Guyer, B., & Paige, D. M. (1994). Differences in gestational age-specific birth-weight among Chinese, Japanese, and white Americans. International Journal of Epidemiology, 23, 119–128. doi:10.1093/ije/23.1.119.

    Article  PubMed  CAS  Google Scholar 

  26. Rhoades, E. R., Brenneman, G., Lyle, J., & Handler, A. (1992). Mortality of American-Indian and Alaska Native infants. Annual Review of Public Health, 13, 269–285. doi:10.1146/annurev.pu.13.050192.001413.

    Article  PubMed  CAS  Google Scholar 

  27. U.S. Department of Education (Ed.). (2005). User’s manual for the ECLS-B nine-month private data file and electronic code book. Washington, DC: U.S. Department of Education.

    Google Scholar 

  28. Geronimus, A. T. (1987). On teenage childbearing and neonatal mortality in United States. Population and Development Review, 13, 245–279. doi:10.2307/1973193.

    Article  Google Scholar 

  29. Geronimus, A. T. (1996). Black/white differences in the relationship of maternal age to birthweight: A population-based test of the weathering hypothesis. Social Science and Medicine, 42, 589–597. doi:10.1016/0277-9536(95)00159-X.

    Article  PubMed  CAS  Google Scholar 

  30. Martin, J., Hamilton, B., Ventura, S., Menacker, F., & Park, M. (2002). Births: Final data for 2000. National Vital Statistics Reports, 50, 1–101.

    Google Scholar 

  31. Reichman, N. E., & Teitler, J. O. (2006). Paternal age as a risk factor for low birthweight. American Journal of Public Health, 96, 862–866. doi:10.2105/AJPH.2005.066324.

    Article  PubMed  Google Scholar 

  32. Kotelchuck, M. (1994). An evaluation of the Kessner Adequacy of Prenatal-Care Index and a proposed adequacy of prenatal-care utilization index. American Journal of Public Health, 84, 1414–1420. doi:10.2105/AJPH.84.9.1414.

    Article  PubMed  CAS  Google Scholar 

  33. Kotelchuck, M. (1994). The adequacy of prenatal-care utilization index—its US distribution and association with low birth weight. American Journal of Public Health, 84, 1486–1489. doi:10.2105/AJPH.84.9.1486.

    Article  PubMed  CAS  Google Scholar 

  34. Perreira, K. M., & Cortes, K. E. (2006). Race/ethnicity and nativity differences in alcohol and tobacco use during pregnancy. American Journal of Public Health, 96, 1629–1636. doi:10.2105/AJPH.2004.056598.

    Article  PubMed  Google Scholar 

  35. Ramakrishnan, U., Kuklina, E., & Stein, A. D. (2002). Iron stores and cardiovascular disease risk factors in women of reproductive age in the United States. The American Journal of Clinical Nutrition, 76, 1256–1260.

    PubMed  CAS  Google Scholar 

  36. Ramos, R. G., & Olden, K. (2008). The prevalence of metabolic syndrome among US women of childbearing age. American Journal of Public Health, 98, 1122–1127. doi:10.2105/AJPH.2007.120055.

    Article  PubMed  Google Scholar 

  37. SAS. (2007). SAS version 9.2. Cary, NC: SAS Institute Inc.

    Google Scholar 

  38. An, A. B. (2002). Performing logistic regression on survey data with the new SURVEYLOGISTIC procedure. In Proceedings of the twenty-seventh annual SAS ® users group international conference. Orlando, FL: SAS Institute Inc.

  39. Shi, L. Y., Stevens, G. D., Wulu, J. T., Politzer, R. M., & Xu, J. H. (2004). America’s health centers: Reducing racial and ethnic disparities in perinatal care and birth outcomes. Health Services Research, 39, 1881–1901. doi:10.1111/j.1475-6773.2004.00323.x.

    Article  PubMed  Google Scholar 

  40. Sparks, P. J. (2009). Do biological, sociodemographic, and behavioral characteristics explain racial/ethnic disparities in preterm births? Social Science & Medicine, 68(9), 1667–1675.

    Article  Google Scholar 

  41. Vintzileos, A. M., Ananth, C. V., Smulian, J. C., Scorza, W. E., & Knuppel, R. A. (2002). The impact of prenatal care in the United States on preterm births in the presence and absence of antenatal high-risk conditions. American Journal of Obstetrics and Gynecology, 187, 1254–1257. doi:10.1067/mob.2002.127140.

    Article  PubMed  Google Scholar 

  42. Lu, M. C., & Halfon, N. (2003). Racial and ethnic disparities in birth outcomes: A life-course perspective. Maternal and Child Health Journal, 7, 13–30. doi:10.1023/A:1022537516969.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The author gratefully acknowledges funding for this project from a Faculty Research Grant from the College of Public Policy at the University of Texas at San Antonio and a Faculty Summer Research Award from the San Antonio Health Services Research Program. This study was approved by the Institutional Review Board of the University of Texas at San Antonio.

Author information

Authors and Affiliations

  1. Department of Demography and Organization Studies, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, USA

    P. Johnelle Sparks

Authors
  1. P. Johnelle Sparks
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. Johnelle Sparks.

Additional information

Some of the data used in this analysis are derived from the restricted-use files of the ECLS-B obtained under special contractual arrangements with the National Center for Education Statistics designed to protect the anonymity of the respondents. These data are not available from the author.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Johnelle Sparks, P. One Size Does Not Fit All: An Examination of Low Birthweight Disparities Among a Diverse Set of Racial/Ethnic Groups. Matern Child Health J 13, 769–779 (2009). https://doi.org/10.1007/s10995-009-0476-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-009-0476-z

Keywords

Search

Navigation