Race and Low Birth Weight in Utah | Categories Utah Women and Perinatal Health | DOI: 10.26054/0KG9C6NTKS

Compiled by Jane M. Dyer, CNM, FNP, MS, MBA

Background

The relationship between race and low birth weight (LBW) is complex and a growing perinatal concern throughout the U.S. and in Utah for parents, health care professionals, health care systems, educators, and legislators. LBW disproportionately affects certain races/ethnicities, especially non-Hispanic blacks and Asian/Pacific Islanders. Barriers to information and care for minority populations include financial, language/cultural, and geographic. Certain characteristics of Utah’s population place it a greater risk for a higher incidence of LBW: rapidly increasing racial minority populations especially Asian/Pacific Islanders, young and rapidly increasing general population, a high birth rate, a few densely populated urban areas with easily accessible assisted reproductive technology, and large expanses of rural/frontier areas with few health care providers. LBW births account for 10% of all U.S. health care costs related to children. Providing education, health care and child care to children of LBW from infancy to age 15 costs the U.S. $5.5 to 6 billion annually. (1) When compared to normal weight infants, health care costs in Utah are 6 times higher for LBW babies weighing and almost 85 times higher for Very Low Birth Weight (infants weighing less than 1500 grams – VLBW) infants. (2)

LBW, babies weighing less than 2500 grams, includes babies born before 37 weeks (preterm or premature – 60% of all LBW babies) and small babies born at term (small for gestation age – SGA and intrauterine growth retardation – IUGR). LBW infants can belong to one or both groups and face unique potential complications.

Healthy People (HP) 2010 objectives and goals specifically address reducing the incidence of LBW and preterm births. The U.S. HP 2010 goal is to reduce LBW to no more than 5% of live births and VLBW to no more than 0.9% of live births. (3) Utah is failing to meet the HP 2010 goals.

Risk Factors

Racial minority groups are more likely to have conditions that are associated with LBW. These include late entry into prenatal care, history of a previous LBW baby, lower income, lower education level, higher incidence of teen pregnancy, smoking, low maternal weight gain, short inter-pregnancy interval, and maternal and fetal medical conditions.  Other risk factors include multiple births (twins, triplets, etc.), maternal age of over 40, and assisted reproductive technologies for infertility problems. Some of the maternal medical conditions associated with LBW are high blood pressure, infections, uterine anomalies, placental insufficiency, and cardiac, kidney, or lung problems. Fetal conditions include defects from genetic or environmental causes.

Utah Data: How are we doing? The overall incidence of LBW and the rates in certain racial groups continues to rise nationally and in Utah. Between 1981 and 2003, the rates of premature births and LBW in the U.S. and in Utah increased. (4)

Table 1: Changes in Preterm and LBW Rates, Utah and the U.S., 1994 and 2004

Since 1989, the actual number of all LBW babies born in Utah dramatically increased from 2,015 in 1989 to 3,520 in 2005 (6.83% of all live births). (5)

Table 2: Actual Number of LBW Babies in Utah, 1989, 1996, and 2005

The incidence of LBW in Utah’s growing racial minority population is consistently higher than Utah’s white population over the last four years. (6)

Table 3: Percent of LBW Births by Maternal Race in Utah

Summary

National, state, and local entities are attempting to address the issues that surround LBW. Local organizations, such as the Utah March of Dimes and certain provider groups, are attempting to increase access to prenatal care.

Departments within the Utah State government produce educational materials for providers and women to prevent LBW, conduct perinatal morbidity and mortality reviews, provide limited prenatal care funding through the Baby Your Baby Program (BYB), provide supplemental food and nutritional education through the Women, Infants, and Children (WIC) Program, and collect birth certificate and Pregnancy Risk Assessment Monitoring System (PRAMS) data to guide interventions. After failing to meet the HP 2000 goals, the Utah State Department of Health (UDOH) addressed the rising incidence of LBW in its Report on Low Birth Weight in Utah in 1999. Almost all of the challenges identified in this report remain the challenges in 2007.

References

  1. Lewit, E., Baker, L., Corman, H., & Shiono, P. 1995. The direct cost of low birth weight, Future Child, 5:35-56.
  2. Utah Department of Health. (2006). Retrieved November 16, 2006, from http://ibis.health.utah.gov/.  
  3. U.S. Department of Health and Human Services (2000). Healthy People 2010.Washington, D.C.
  4. March of Dimes Birth Defects Foundation, (November, 2006). Babies Born too Soon. Retrieved December 17, 2006 from http://www.marchofdimes.com/peristats.
  5. Utah Department of Health. (2006). Retrieved November 16, 2006, from http://ibis.health.utah.gov/.
  6. Utah Department of Health. (2006). Retrieved November 16, 2006, from http://ibis.health.utah.gov/. 

Jane M. Dyer

Jane M. Dyer, CNM, FNP, MS, MBA