Higher SocioEconomic Status and Adverse Birth Outcomes for Black Women

Citation

Brant, Marisa; Wade, Roy; Passarella, Molly; Martin, Ashley; & Lorch, Scott (2017). Higher SocioEconomic Status and Adverse Birth Outcomes for Black Women. Pediatric Academic Societies Meeting. San Francisco, CA.

Abstract

Background: Black infants born in the US are almost twice as likely to have a low birthweight and 1.5 times more likely to be born preterm when compared to white infants born in the US. This disparity is frequently attributed to the socioeconomic (SE) disadvantage associated with the black race, but less data exists on adverse birth outcomes amongst black women of higher SE status. Objective: To examine the relationship between maternal race/ethnicity and adverse birth outcomes (ABOs), including small for gestational age (SGA), low birthweight < 2.5kg (LBW), preterm birth, and death during the birth hospitalization, and to determine if higher education or income status reduced any observed racial/ethnic disparities in ABOs. Design/Methods: We constructed a retrospective cohort of female adolescents surveyed in grades 7-12 as part of The National Longitudinal Study of Adolescent to Adult Health (Add Health), who were followed for 15 years with at least 1 follow-up survey, and reported a live birth during the final wave of interviews (N=4652 women with 9211 livebirths). Univariable and logistic multivariable regression models determined the association between race/ethnicity and each ABO after controlling for maternal medical comorbidities, both for the entire cohort and then stratified by maternal education level, household income, insurance status, and employment. Results: 53% of the cohort was white and 25% was black. Overall, in univariable analyses black women had consistently greater odds of all ABOs (Table 1). While increasing education and income status was associated with improvements in outcomes for both black and white women, disparities persisted such that black women with more than a high school education and higher incomes had similar rates of each ABO as white women with less than a high-school education and lower incomes. Such differences persisted in multivariable models (Table 2). As shown, black women in the highest education and SE groups had a similar increased odds of having ABOs as white women with less than high school education or lower SE status. Conclusion(s): While adverse birth outcomes are more frequently associated with lower SE status, we observed that for black women, having higher education, improved income, health insurance and employment does not eliminate the added risk of having infants born SGA or extremely preterm, as is seen with white women. Further data on the life course events that result in higher risk of ABO, including experiences with racism, chronic stress, and discrimination, are needed. Publication Number: 4610.8

Reference Type

Conference proceeding

Book Title

Pediatric Academic Societies Meeting

Author(s)

Brant, Marisa
Wade, Roy
Passarella, Molly
Martin, Ashley
Lorch, Scott

Year Published

2017

City of Publication

San Francisco, CA

Reference ID

6751