Introduction
Non-Hispanic Black infants experience disproportionately high risks of low birth weight
compared with non-Hispanic White infants, particularly among mothers with high educational
attainment and greater socioeconomic advantage. This study investigates how maternal
early-life disadvantage contributes to ongoing racial birth weight inequities among
U.S. college‒educated mothers, specifically declining birth weights with age among
non-Hispanic Black mothers.
Methods
Study analyses used cohort data from the National Longitudinal Study of Adolescent
to Adult Health. Racial inequities in birth weight by maternal age and early-life
disadvantage were assessed using completed reproductive histories among college-educated
mothers at ages 33–44 years collected in 2016‒2018 and regression-based marginal standardization
techniques. Early-life disadvantage was measured using a study-based composite measure
of early-life concentrated poverty and social disadvantage in homes, neighborhoods,
and schools, collected in previous waves. Primary analyses were completed in 2020‒2021.
Results
Among non-Hispanic Black mothers who experienced high early-life disadvantage, a 1-year
increase in maternal age at delivery was associated with lower birth weight by 26.07
g (95% CI= −48.74, −3.40). Similar declines were not found among non-Hispanic Black
mothers with low early-life disadvantage. Non-Hispanic White mothers experienced increased
birth weight with maternal age, 6.85 g (95% CI= −1.12, 14.82) per year, which did
not significantly vary by early-life disadvantage.
Conclusions
Early-life disadvantage modifies whether and how college-educated mothers experience
birth weight decline with older age. The effects of early-life contexts and embedded
racial inequities on maternal health inequities and differential weathering warrant
further public health attention.
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Published online: February 16, 2022
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