Trends in infants born at low birthweight and disparities by maternal race and education from 2003 to 2018 in the United States

Elizabeth A Pollock,David Kindig,Marjory L Givens,Keith P Gennuso

doi:10.1186/s12889-021-11185-x

Abstract

BackgroundUnderstanding current levels, as well as past and future trends, of the percentage of infants born at low birthweight (LBW) in the United States is imperative to improving the health of our nation. The purpose of this study, therefore, was to examine recent trends in percentage of LBW, both overall and by maternal race and education subgroups. Studying disparities in percentage of LBW by these subgroups can help to further understand the health needs of the population and can inform policies that can close race and class disparities in poor birth outcomes.MethodsTrends of percentage of LBW in the U.S. from 2003 to 2018, both overall and by race/ethnicity, and from 2007 to 2018 by education and race by education subgroups were analyzed using CDC WONDER Natality data. Disparities were analyzed using between group variance methods.ResultsPercentage of LBW experienced a significant worsening in the most recent 5 years of data, negating nearly a decade of prior improvement. Stark differences were observed by race/ethnicity and by education, with all subgroups experiencing increasing rates in recent years. Disparities also worsened over the course of study. Most notably, all disparities increased significantly from 2014 to 2018, with annual changes near 2–5%.ConclusionsRecent reversals in progress in percentage of LBW, as well as increasing disparities particularly by race, are troubling. Future study is needed to continue monitoring these trends and analyzing these issues at additional levels. Targets must be set and solutions must be tailored to population subgroups to effectively make progress towards equitable birth outcomes and maternal health.

Highlights

The percentage of infants born at low birthweight (LBW), or the percentage of live births where the infant weighed less than 2500 g, is an important population health outcome measure, reflecting both maternal health and infant health
LBW as an outcome is disproportionately prevalent among certain population groups, those that have experienced inequities, or unfair disparities, like mothers with lower social and economic status and mothers who are Black, due in part to unequal opportunity, differential access to quality health care, and chronic stress related to economic or social adversity such as discrimination and racism [8,9,10]. For these reasons and numerous more, understanding current levels, as well as past and future trends, of percentage of LBW in the United States is imperative to improving the health of our nation
Percentage of LBW data were collected for the entire U.S population, as well as for subsets by maternal race, education, and the combination of race by education

Summary

Introduction

The percentage of infants born at low birthweight (LBW), or the percentage of live births where the infant weighed less than 2500 g, is an important population health outcome measure, reflecting both maternal health and infant health. Children born at LBW face myriad health issues over the life course, including greater risk of developmental and growth problems, cardiovascular disease, and respiratory conditions. They have higher rates of cognitive problems such as cerebral palsy, and visual, auditory, and intellectual impairments [4,5,6,7]. Studying disparities in percentage of LBW by these subgroups can help to further understand the health needs of the population and can inform policies that can close race and class disparities in poor birth outcomes

Methods

Results

Conclusion