Racial Differences in Young Adult Resilience and Associations with Low Birth Weight


Montoya-Williams, Diana; Passarella, Molly; & Lorch, Scott (2019). Racial Differences in Young Adult Resilience and Associations with Low Birth Weight. Pediatric Academic Societies Meeting. Baltimore, MD.


Background: Resilience to stress may mediate the development of poor mental and physical health outcomes. Given that adverse maternal psychosocial environments are believed to contribute to racial disparities in birth outcomes, disparities in resilience between racial/ethnic groups might amplify these effects. The existence of such disparities and their potential effect on birth outcomes is unknown. Objective: Describe differences in resilience by race and ethnicity, and associations between resilience and low birth weight (LBW). Design/Methods: We constructed a retrospective cohort of 5774 young adults surveyed repeatedly as part of The National Longitudinal Study of Adolescent to Adult Health (Add Health). Wave 4 questions which mirrored items on the Connor-Davidson Resilience Scale 10 were pulled. Factor analysis was performed on participants’ responses to these questions to construct an Add Health-based resilience scale. Racial differences in resilience scores were measured via bivariate and multivariate analyses after adjusting for education, household income, age and BMI. Multivariate regression models explored the association between resilience, as measured by tertiles, and LBW after adjusting for maternal socioeconomic status, age, BMI, smoking/alcohol history and prenatal care. Results: Non-Hispanic American Indians (NHAIs) had the lowest resilience scores across all races (Table 1). In poisson regression models, NHAIs and NH Asians had lower resilience scores compared to NH Whites (Table 2). When these models were sequentially adjusted for covariates, NH Blacks had higher resilience scores than NHWs (IRR 1.04, 95% CI 1.02-1.07) while NHAI and NHAs scores remained lower than NHWs. Women with resilience scores in the mid or high tertiles were progressively less likely to deliver a LBW infant (Table 3). These findings persisted in multivariable analyses (aOR 0.72, 95% CI 0.53-0.97 for highest tertile in full model). Finally, NH Black women had a 2-fold higher risk of LBW compared to other racial/ethnic groups if they were in the low resilience tertile (aOR 2.03, 95% CI 1.34-3.09). There was no such worsening effect for NHBs at the mid and higher resilience tertiles. Conclusion(s): Resilience scores were lowest among NHAIs. Resilience may act as a buffer against risk of LBW, particularly among NHBs. Alternatively, low resilience may be an indicator of the psychosocial environment most associated with the phenotype of LBW. Increasing resilience among at-risk women may prove a useful public health strategy to decrease LBW rates.

Reference Type

Conference proceeding

Book Title

Pediatric Academic Societies Meeting


Montoya-Williams, Diana
Passarella, Molly
Lorch, Scott

Year Published


City of Publication

Baltimore, MD

Reference ID