Aggregation of low birth weight among whites and blacks in the United States

Background. Studies have shown that the birth weight of infants is correlated with the birth weights of their siblings and their mothers. We investigated whether the birth weights of mothers and index children were jointly associated with the risk of low birth weight in the siblings of the index children. Methods. We used data on the live-birth cohort of the 1988 National Maternal and Infant Health Survey, The analysis included 1691 white and 1461 black mothers, each of whom had two or more live-born, singleton children, Multiple logistic regression with generalized-estimation equations was used to assess the risk of low birth weight among an index child's siblings, Four groups were studied: that in which neither the mother nor the index child had low birth weight (group 1), that in which only the mother had low birth weight (group 2), that in which only the index child had low birth weight (group 3), and that in which both the mother and the index child had low birth weight (group 4). There was adjustment for other maternal and infant covariates. Results. In groups 1, 2, 3, and 4, respectively, 3.6, 8.3, 21.2, and 38.9 percent of white siblings had low birth weights, as compared with 8.0, 19.0, 31.1, and 57.1 percent of black siblings, When group 1 was used as the reference group, the adjusted odds ratios (and 95 percent confidence intervals) for low birth weight in groups 2, 3, and 4 were 2.5 (1.4 to 4.3), 6.8 (4.7 to 9.8), and 15.4 (9.2 to 25.5), respectively, among white siblings and 2.6 (1.8 to 3.8), 4.7 (3.5 to 6.4), and 13.9 (9.2 to 20.9) among black siblings. These associations were consistently found for birth weights below 1500 g and those ranging from 1500 to 2499 g in both races and after stratification for the mother's age, parity, education, cigarette-smoking status, and weight and height before pregnancy and the infant's sex. Conclusions. Although the possibility of selection and recall biases cannot be excluded with certainty, our data suggest a strong familial aggregation of low birth weight among both whites and blacks in the United States.