Birth weight, maternal age, and education: New observations from Connecticut and Virginia

It has been well established that increased maternal education, income, and social status contribute to increased birth weight, as well as reduced ris k for low or very low birth weighs offspring. However there remains controv ersy about the mechanism(s) for this effect, as well as the interactions be tween these factors, maternal age, and race. Presented here is the analysis of a large, recent sample of over 20,000 con secutive live births in 12 hospitals, about half in Connecticut and half in Virginia, including a maternal population that is educationally and racial ly diverse. Although information on potentially relevant details such as pr enatal care, smoking, occupation, and neighborhood is lacking the data set, there is sufficient information to explore the previously noted strong eff ect of maternal education on birth weight, as well as the large racial diff erence in outcome at every educational level after adjustment for the effec ts of age, marital status, state of residence, and gender of the offspring. However this relationship was not monotonic, and there were differences in the effect between the white and black families, with black women showing a linear and consistent benefit from education across the range, while whit es show a sharp benefit from completion of primary education, less from sub sequent schooling. A surprising result was the apparent negative impact of vent advanced education (>16 years), with lowered birth weights and higher risk of low birth weight offspring in the women with post-college training. The data also shed some addition Eight on the effect of age and birth weigh t. Whites show established improvement in birth outcome to about age 30, wi th slight decline thereafter whereas in blacks there was progressive declin e in birth weight with rising age starting in adolescence, as previously de monstrated by Geronimus. An additional unexpected observation was a sizable difference between births in Connecticut (larger; fewer low birth weight) than Virginia, correcting for all other covariates. Ii is hypothesized that this may reflect differences in services used prenatal care in particular; given similarities in smoking rates and other predictors. Because of the non-representiveness of and the limited information availabl e in the present study, the conclusions should be taken as hypotheses for f urther research rather than definitive.