RACIAL AND ETHNIC-DIFFERENCES IN DETERMINANTS OF INTRAUTERINE GROWTH-RETARDATION AND OTHER COMPROMISED BIRTH OUTCOMES

Objectives. This study examined the extent of variation by race/ethnic ity in the prevalence of adverse birth outcomes, whether differentials persisted after other risk factors were controlled for, and whether t he direction and magnitude of relationships differed by type of outcom e. Methods. A revised system of measurement was used to estimate multi nomial logistic models in a large, nationally representative US data s et. Results. Considerable racial/ethnic variation was found across bir th outcome categories; differences persisted in the adjusted parameter estimates; and the effects of other risk factors on birth outcomes we re similar as to direction, but varied somewhat in magnitude. The odds of compromised birth outcomes were much higher among African American s than among Mexican Americans and non-Hispanic Whites. Conclusions. I n addition to persistent racial inequality, we found strong adverse ef fects of both inadequate and ''adequate-plus'' prenatal care and smoki ng. Risk of intrauterine growth retardation was higher in the absence of medical insurance, and risk of all adverse birth outcomes was lower among mothers participating in the Special Supplemental Food Program for Women, Infants, and Children.