title: Very low birth weight births in Georgia, 1994-2005: trends and racial disparities.
abstract: OBJECTIVE
  To investigate the nature of very low birth weight (VLBW) births in Georgia-a major contributor to the overall and the black-white disparity in infant mortality-as a step toward elucidating strategies for reducing VLBW births.
  
  
  METHODS
  This population-based retrospective cohort study utilized maternally linked vital records data from Georgia to examine the status of and contributors to the VLBW rate for non-Hispanic blacks and whites by comparing trends in the proportion represented by singleton versus multiple gestations, first versus recurrent events, and specific subtypes over three, consecutive 4-year periods (1994-1996 through 2003-2005); and logistic regression to model the risk of various subtypes of VLBW as a function of maternal and obstetrical characteristics.
  
  
  RESULTS
  Georgia's VLBW rate remained unchanged from 1994-1996 to 2003-2005, although there was a significant decrease in the rates of twin and first VLBW and a significant increase in recurrent VLBW. For both first and recurrent VLBW, there was a statistically significant increase for blacks and a decrease for whites. The strongest risk factor for a VLBW birth of any subtype for blacks and whites was a prior VLBW, with recurrent VLBW accounting for 4.8-16% of all VLBW depending upon the subtype.
  
  
  CONCLUSIONS
  From 1994-1996 to 2003-2005, the rate of recurrent VLBW increased while the rate of first VLBW decreased in Georgia. For both first and recurrent VLBW, the black-white disparity widened. Because the strongest risk factor for a VLBW birth is a previous one, there is a need to identify strategies to prevent a woman's first VLBW birth and to reduce recurrences.
authors.affiliation: Department of Family & Preventive Medicine, Emory University School of Medicine, 1256 Briarcliff Road NE, Building A, Suite 238, Atlanta, GA, 30322, USA. amlang@emory.edu
authors.forename: Anne L
authors.initials: AL
authors.lastname: Dunlop
authors.forename: Hamisu M
authors.initials: HM
authors.lastname: Salihu
authors.forename: Gordon R
authors.initials: GR
authors.lastname: Freymann
authors.forename: Colin K
authors.initials: CK
authors.lastname: Smith
authors.forename: Alfred W
authors.initials: AW
authors.lastname: Brann
mesh_terms: D000328:Adult; D001741:Black or African American; D015331:Cohort Studies; D005845:Georgia / Q000453:epidemiology; D054624:Health Status Disparities; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D012189:Retrospective Studies; D014798:Vital Statistics; D044465:White People