Introduction
Reproductive rights policies can potentially support or inhibit individuals’ abilities
to attain the highest standard of reproductive and sexual health; however, research
is limited on how broader social policies may differentially impact women of color
and immigrants in the U.S. This study examines the associations among state-level
reproductive rights policies, race, and nativity status with preterm birth and low
birth weight in the U.S.
Methods
This was a retrospective, cross-sectional analysis of all births occurring within
all the 50 states and the District of Columbia using vital statistics birth record
data in 2016 (N=3,945,875). Modified log-Poisson regression models with generalized
estimating equations were fitted to estimate the RR of preterm birth and low birth
weight associated with tertiles of the reproductive rights policies index. Analyses
were conducted between 2019 and 2020.
Results
Compared with women in states with the most restrictive reproductive rights policies,
women living in the least restrictive states had a 7% lower low birth weight risk
(adjusted RR=0.93, 95% CI=0.88, 0.99). In particular, low birth weight risk was 8%
lower among Black women living in the least restrictive states than among their counterparts
living in the most restrictive states (adjusted RR=0.92, 95% CI=0.86, 0.99). In addition,
low birth weight risk was 6% lower among U.S.-born Black women living in the least
restrictive states than among those living in the most restrictive states, but this
was marginally significant (adjusted RR=0.94, 95% CI=0.89, 1.00). No other significant
associations were found for race–nativity-stratified models.
Conclusions
Women living in states with fewer restrictions related to reproductive rights have
lower rates of low birth weight, especially for Black women.
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Article Info
Publication History
Published online: October 13, 2020
Identification
Copyright
© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
