Relation of African-American Mother's Perception of Their Residential Environment to Very Low Birth Weight (<1500g, VLBW): An Exploratory Study. † 1140

For unclear reasons, African-Americans have a three-fold greater incidence of VLBW infants than whites. Only recently have researchers begun to suspect that factors closely related to residential segregation underlie this epidemiologic enigma. We performed a case-control study of African-American mothers to explore the relationship perception of residential environment and VLBW rates. Cases were African-American mothers of VLBW infants admitted to the neonatal intensive care unit at a tertiary care hospital between 1993-1996. Controls were African-American mothers of critically ill non-low birth weight (≥ 2500g, non-LBW) infants admitted to the same neonatal intensive care unit. Trained African-American interviewers administered a structured questionnaire to both subgroups. There were no differences between cases and controls with respect to maternal age, education, marital status, insurance status, income, and trimester of prenatal care initiation. The Table shows the distribution and OR for low ratings of selected aspects of residential environment.

Table 1

The crude OR for an overall low rating of residential environment was 3.2(1.2-8.8). Control of maternal alcohol intake, illicit drug usage, and duration of residence in a logistic regression model reduced the OR to 1.8(1.1-3.0). The study provides new information suggesting an association between unfavorable perception of residential environment and VLBW among urban African-American mothers.