Learning Objectives: Assess if race is a determinant of Low Birth Weight
Abstract: Problem: The assumption that race is a determinant of low birth weight (LBW) is based on
research that uses race collectively as a comparison tool to determine the differences between
races. Studies have found that blacks smoke fewer cigarettes than whites during pregnancy,
however, LBW is more prevalent in blacks.
Methods: Data from the Smoking Cessation or Reduction in Pregnancy Trial were analyzed.
Participants recruited from 10 public health clinics in eight counties reflect the census and racial
variations needed to demonstrate a representative sample in Alabama. Saliva cotinine tests were
conducted to corroborate self-reported smoking status. Birth weights were obtained from birth
certificates.
Results: Separate analyses were performed by race. Of the 1,262 participants, 28% were black,
were approximately 22 years old and had less than a high school diploma. Fifty-four percent
were married and the average gestation at birth was 39 weeks. Eighty-three percent of the self-
reported smokers were white and 44% were black. Analysis indicated an association with higher
mean birth weight and smoking among white participants (p=.000). There were no significant
associations with higher mean birth weight and smoking among black participants (p=.211). A
regression analysis among blacks indicated that there were no associations found between lower
birth weight and being a cotinine-confirmed smoker (p=.339).
Conclusions: LBW among black infants has been found to be different from that of white
infants. Comparisons of LBW among groups should be limited to variables other than race.
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