title: Intergenerational effects of high socioeconomic status on low birthweight and preterm birth in African Americans.
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.
authors.affiliation: Department of Obstetrics and Gynecology, Meharry Medical College, Nashville, Tennessee 37208-3599, USA.
authors.forename: H W
authors.initials: HW
authors.lastname: Foster
authors.forename: L
authors.initials: L
authors.lastname: Wu
authors.forename: M B
authors.initials: MB
authors.lastname: Bracken
authors.forename: K
authors.initials: K
authors.lastname: Semenya
authors.forename: J
authors.initials: J
authors.lastname: Thomas
authors.forename: J
authors.initials: J
authors.lastname: Thomas
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009035:Mothers; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D012044:Regression Analysis; D012307:Risk Factors; D012923:Social Class