Article

Maternal and Child Health Journal

, Volume 10, Issue 1, pp 39-46

First online:

Maternal Hypertension as a Risk Factor for Low Birth Weight Infants: Comparison of Haitian and African-American Women

  • Christine D. OdellAffiliated withDepartment of Family Medicine, Boston Medical Center/Boston University School of MedicineDepartment of Maternal and Child Health, Boston University School of Public Health
  • , Milton KotelchuckAffiliated withDepartment of Maternal and Child Health, Boston University School of Public Health
  • , V. K. ChettyAffiliated withDepartment of Family Medicine, Boston Medical Center/Boston University School of Medicine
  • , Josephine FowlerAffiliated withDepartment of Family Medicine, Boston Medical Center/Boston University School of MedicineDepartment of Maternal and Child Health, Boston University School of Public Health
  • , Phillip G. StubblefieldAffiliated withDepartment of Maternal and Child Health, Boston University School of Public HealthDepartment of Obstetrics and Gynecology, Boston Medical Center/Boston University School of Medicine
  • , Malena OrejuelaAffiliated withMassachusetts Department of Public Health
  • , Brian W. JackAffiliated withDepartment of Family Medicine, Boston Medical Center/Boston University School of MedicineBoston Medical Center, Dowling 5 South, 1 BMC Place Email author 

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Background: The rate of low birth weight (LBW) of Black women is more than twice that of White women. This study explores if the rate of LBW differs between Haitian and African-American women with chronic hypertension. Methods: A retrospective cohort study of all Black women self-identified as African-American (n = 12,258) or Haitian (n = 4320) delivering a singleton infant in Massachusetts between 1996 and 2000. Results: Haitian women were more likely than African-American women to have chronic hypertension (2.7% vs. 2.1%, p = 0.006), but had similar rates of preeclampsia (3.1% vs. 3.3%, p = 0.27). The LBW rate was 10% among African-American women and 8.2% among Haitian women. After adjustment for sociodemographic, medical, and prenatal care characteristics, the greatest risks for delivering a LBW infant for Haitian women were chronic hypertension (OR = 6.8; 95% CI, 4.3, 10.6) and preeclampsia (OR = 3.2; 95% CI, 2.0, 5.1). For African-American women, the greatest risks for LBW infants were a history of delivering a LBW infant (OR = 3.9; 95% CI, 2.8, 5.4) and chronic hypertension (OR = 2.9; 95% CI, 2.1, 4.0). In a combined logistic regression model including interaction terms, chronic hypertension and preeclampsia continued to be associated with the greatest risk of LBW among all women. Conclusions: Differences in maternal risk factors and rates of LBW (8.2% vs. 10%) exist between Haitian and African-American women delivering infants in Massachusetts. While chronic hypertension and preeclampsia are strong risk factors for LBW for both Haitian and African-American women, unknown factors make these disorders much more potent for Haitian women.

KEY WORDS:

Low birth weight maternal hypertension racial disparities.