Medical, psychosocial, and behavioral risk factors do not explain the increased risk for low birth weight among black women.
OBJECTIVE
Our purpose was to determine whether various demographic, behavioral, housing, psychosocial, or medical characteristics explain the difference in pregnancy outcome between black and white women.


METHODS
A sample of 1491 multiparous women with singleton pregnancies, 69% of whom were black and 31% of whom were white and who enrolled for care between Oct. 1, 1985, and March 30, 1988, participated in the study. The frequencies of various demographic, medical environmental, and psychosocial risk factors among black and white women were determined. The outcome measures were birth weight, gestational age, fetal growth restriction, preterm delivery and low birth weight.


RESULTS
White infants were heavier and born later than black infants. The white women in this sample smoked more cigarettes, moved more frequently, and had worse psychosocial scores. The black women had lower incomes, were less likely to be married, and had more hypertension, anemia, and diabetes. Besides race, only maternal height, weight, blood pressure, diabetes, and smoking had a consistent impact on outcome and did not explain the difference in outcome between the two groups.


CONCLUSIONS
In this low-income population, many of the risk factors for low birth weight were more common among white women than black women. Nevertheless, black women had more infants born preterm, with growth restriction, and with low birth weight than did white women. The various maternal characteristics studied did not explain these differences.
Goldenberg
R L
RL
Department of Obstetrics and Gynecology, University of Alabama at Birmingham, USA.
Cliver
S P
SP
Mulvihill
F X
FX
Hickey
C A
CA
Hoffman
H J
HJ
Klerman
L V
LV
Johnson
M J
MJ
D044383:Black People; D005260:Female; D005317:Fetal Growth Retardation / Q000208:ethnology / Q000209:etiology*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D001523:Mental Disorders / Q000150:complications; D007752:Obstetric Labor, Premature / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D044465:White People