Exploring Weathering: Effects of Lifelong Economic Environment and Maternal Age on Low Birth Weight, Small for Gestational Age, and Preterm Birth in African-American and White Women

Abstract

There is a black-white disparity in birth outcomes. The risk of a low birth weight (LBW) infant and infant death is about twice more likely among African-American women than among non-Hispanic white women. Several studies have demonstrated worsening birth outcomes with increasing maternal age in African-American women; this phenomenon has been referred to as Some investigators have suggested that weathering may result from the cumulative effect of socioeconomic disadvantages on the health of African-American women. Prior studies reported more frequent occurrence of weathering among African-American mothers living in low-income neighborhoods during pregnancy, even after adjustment for maternal health characteristics. There are little data on the effect of early life environment on weathering. The present study tested the hypothesis that African-American women who had never been exposed to poverty in low-income areas would not experience weathering, and that white women exposed to poverty throughout their life would show evidence of weathering. Data obtained from a transgenerational birth file for 2 generations of birth outcomes were linked to economic data from the census. The birth outcomes examined were LBW, small for gestational age (SGA), and preterm birth (PTB). The data showed that African-American women born in poorer neighborhoods and still poor as mothers had significant weathering with respect to LBW and SGA, but not PTB. Unlike African-American women, white women showed no evidence of weathering with respect to LBW, SGA, or PTB, even those with lifetime exposure to poorer neighborhoods. The findings demonstrate that the extent of weathering in African-American women is related to the length of exposure to low-income neighborhoods and that weathering does not occur in white women of any income status. The data suggest that improving the economic environment of pregnant African-American women can improve their birth outcomes with increasing maternal age.