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. 2021 Jun 10;21(1):1117.
doi: 10.1186/s12889-021-11185-x.

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  1 , Keith P Gennuso  2 , Marjory L Givens  2 , David Kindig  2
Affiliations

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 et al. BMC Public Health. .

Abstract

Background: Understanding 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.

Methods: Trends 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.

Results: Percentage 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%.

Conclusions: Recent 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.

Keywords: Education; Health disparities; Low birthweight; Race; Trend analysis; United States.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Trends in LBW, United States, 2003–2018. LBW = Low Birthweight
Fig. 2
Fig. 2
Trends in LBW by Maternal Race, United States, 2003–2018. LBW = Low Birthweight. AIAN = American Indian and Alaska Native
Fig. 3
Fig. 3
Trends in LBW by Maternal Education, United States, 2007–2018. LBW = Low Birthweight. HS = High School
Fig. 4
Fig. 4
Trends in LBW by Maternal Race and Education Combined, United States, 2007–2018. LBW = Low Birthweight. AIAN = American Indian and Alaska Native. LHS = Less than High School. HS = High School. SC = Some College. Coll = College
Fig. 5
Fig. 5
Trends of Disparities in LBW by Maternal Race, Education, and Their Combination, United States, 2003–2018. LBW = Low Birthweight. BGV = Between Group Variance
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