, Volume 15, Issue 7, pp 890-898
Date: 11 Mar 2010

Very low birth weight births in Georgia, 1994–2005: trends and racial disparities

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Abstract

Objective

To investigate the nature of very low birth weight (VLBW) births in Georgia—a major contributor to the overall and the black–white disparity in infant mortality—as a step toward elucidating strategies for reducing VLBW births.

Methods

This population-based retrospective cohort study utilized maternally linked vital records data from Georgia to examine the status of and contributors to the VLBW rate for non-Hispanic blacks and whites by comparing trends in the proportion represented by singleton versus multiple gestations, first versus recurrent events, and specific subtypes over three, consecutive 4-year periods (1994–1996 through 2003–2005); and logistic regression to model the risk of various subtypes of VLBW as a function of maternal and obstetrical characteristics.

Results

Georgia’s VLBW rate remained unchanged from 1994–1996 to 2003–2005, although there was a significant decrease in the rates of twin and first VLBW and a significant increase in recurrent VLBW. For both first and recurrent VLBW, there was a statistically significant increase for blacks and a decrease for whites. The strongest risk factor for a VLBW birth of any subtype for blacks and whites was a prior VLBW, with recurrent VLBW accounting for 4.8–16% of all VLBW depending upon the subtype.

Conclusion

From 1994–1996 to 2003–2005, the rate of recurrent VLBW increased while the rate of first VLBW decreased in Georgia. For both first and recurrent VLBW, the black–white disparity widened. Because the strongest risk factor for a VLBW birth is a previous one, there is a need to identify strategies to prevent a woman’s first VLBW birth and to reduce recurrences.