RISK OF LOW-BIRTH-WEIGHT INFANTS AMONG BLACK-AND-WHITE PARENTS

Objective: To determine whether racial differences in risk of low birt h weight infants among black and white parents can be attributed to di fferences in demographic, behavioral, medical, and socioeconomic facto rs. Methods: We analyzed 203,815 singleton births from the 1992 Califo rnia birth certificate data set for the risk of very low birth weight (500-1499 g) and moderately low birth weight (1500-2499 g) infants. Ad ditional study variables included maternal (rare, age, education, mari tal status, parity, obstetric history, tobacco use, medical complicati ons, medical insurance, and use of prenatal care), paternal (race, age , and education), infant (gestational age and gender), and community ( median household income from the 1990 US Census) characteristics. Resu lts: For both very low and moderately low birth weight infants, the un adjusted risk associated with parental race showed a gradient of risk, from highest to lowest, for black mother/black father, black mother/w hite father, white mother/black father, and white mother/white father parents, After adjusting for other risk factors, the odds ratio associ ated with black mother/black father parents was reduced from 3.37 to 1 .73 for very low birth weight infants and from 2.51 to 1.60 for modera tely low birth weight infants, but both remained elevated. Interracial parents no longer had an elevated risk of very low birth weight infan ts and white mother/black father parents no longer had an elevated ris k of moderately low birth weight, compared with white parents. Conclus ion: After controlling for parental, infant, and community factors, mo st but not all of the increased risk of low birth weight infants assoc iated with black parental race eras explained. (Obstet Gynecol 1998;92 :814-22. (C) 1998 by The American College of Obstetricians and Gynecol ogists.)