PERINATAL OUTCOME OF BROKEN MARRIAGE IN THE INNER-CITY

Objective: To test the hypothesis that the erosion of family structure , epidemic substance abuse, and increased low birth weight (LBW) rates are interrelated. Methods: In this cohort study, we analyzed informat ion coded prospectively in a computerized perinatal data base. Separat ed, divorced, and widowed mothers were grouped as broken marriages. Th e setting was a predominantly urban, indigent population in a tertiary care hospital. The analysis included singleton pregnancies of 14,896 women receiving prenatal and intrapartum care at our hospital from 198 6-1991. The main outcome measures included LBW, prematurity, small for gestational age, neonatal mortality, and neonatal intensive care unit admissions. Results: Married mothers fared better than single mothers , but risks for adverse perinatal outcomes for women with broken marri ages were consistently as high or higher than for single mothers. The rate of LBW infants was 43% higher in the broken marriage group than i n the married group. The increased frequency of LBW among infants born into broken marriages was attributable mainly to reduced growth rathe r than to prematurity and was associated with substance abuse. Conclus ion: Our findings indicate that mothers from broken marriages are at r elatively higher risk for LBW infants than married mothers (odds ratio 1.5). Broken marriage warrants emphasis as an important perinatal ris k factor.