Abstract
Disparities in birthweight by maternal race/ethnicity are commonly observed. It is unclear to what extent these disparities are correlates of individual socioeconomic factors. In a prospective cohort of 1645 low-risk singleton pregnancies included in the NICHD Fetal Growth Study (2009–2013), neonatal anthropometry was measured by trained personnel using a standard protocol. Socioeconomic characteristics included employment status, marital status, health insurance, annual income, and education. Separate adjusted generalized linear models were fit to both test the effect of race/ethnicity and the interaction of race/ethnicity and socioeconomic characteristics on neonatal anthropometry. Mean infant birthweight, length, head circumference, and abdominal circumference all differed by race/ethnicity (p < 0.001). We observed no statistically significant interactions between race/ethnicity and full-time employment/student status, marital status, insurance, or education in association with birthweight, neonatal exam weight, length, or head or abdominal circumference at examination. The interaction between income and race/ethnicity was significant only for abdominal circumference (p = 0.027), with no other significant interactions for other growth parameters, suggesting that racial/ethnic differences in neonatal anthropometry did not vary by individual socioeconomic factors in low-risk women. Our results do not preclude structural factors, such as lifetime exposure to poverty, as an explanation for racial/ethnic disparities.
Highlights
Race/ethnic disparities in pregnancy outcomes continue to be a pressing public health issue [1], and identifying contributing factors to these disparities is an ongoing area of research
This was a secondary analysis of the NICHD Fetal Growth Studies–Singletons, a prospective cohort study across 12 community and perinatal centers between July 2009 and January 2013 [13]
18–40 years; pre-gravid body mass index (BMI) 19.0–29.9 kg/m2 calculated from recalled pre-pregnancy weight and height; viable singleton pregnancy between 8 weeks 0 days (8w0d) to 13 weeks 6 days with gestational age consistent with the last menstrual period dating within a prescribed range per screening sonogram
Summary
Race/ethnic disparities in pregnancy outcomes continue to be a pressing public health issue [1], and identifying contributing factors to these disparities is an ongoing area of research. A survey found that both poor (defined as households with incomes less than 100% of the federal poverty level) black, and white women were more likely to deliver low birthweight infants than their counterparts with higher incomes, while poor white women had lower rates of low birthweight, small for gestational age and preterm birth than affluent black women [5]. These findings have been corroborated by a number of other studies [6,7], highlighting the complexity of associations between socioeconomic factors, race, and fetal growth
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