Intergenerational effects of high socioeconomic status on low birthweight and preterm birth in African Americans |
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Authors: | Foster H W Wu L Bracken M B Semenya K Thomas J Thomas J |
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Affiliation: | Department of Obstetrics and Gynecology, Meharry Medical College, Nashville, Tennessee 37208-3599, USA. |
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Abstract: | As socioeconomic status (SES) increases, the incidence of low birthweight and preterm birth decreases irrespective of social class. However, low birthweight remains twice as high for African-American women as for white women even when SES is controlled. This study examines to what extent second generation high SES African-American women experience improvement in birthweight and gestational age. One hundred eighty-nine former Meharry students were surveyed. Identified were 934 births that are the children and grandchildren of these students who matriculated at Meharry. These infants are compared with a cohort of white mothers from a study in the School of Public Health at Yale University. Low birthweight was reduced in the third generation high SES African-American children (6.9%) from the second generation (11.4%) but remained higher than white children (3.3%). Results showed that African-American third generation children remained at higher risk for low birthweight than were white children (relative risk [RR], 1.78; 95% confidence interval [CI], 1.03, 3.09). Similar results were observed for preterm delivery where the increased risk to third generation African-American children was 3.16 (1.89, 5.27). Persistent strong ethnic differences in birthweight in this high SES cohort (OR = 3.16, 95% CI, 1.89-5.27) support a conclusion that African-American women have birthweight distributions that are somewhat lighter than white women. This may explain a portion of current ethnic differences in birthweight. It is also possible that persistent psychosocial and behavioral factors continue to negatively influence birthweight, even in second generation high SES African-American mothers. This explanation will require identification of powerful risk factors, which are largely unrelated to those presently under investigation. |
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