Skip to main content
NCBI home page
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2002 Sep;94(9):770–778.

Why do foreign-born blacks have lower infant mortality than native-born blacks? New directions in African-American infant mortality research.

Kenneth D Rosenberg 1, Rani A Desai 1, Jianli Kan 1
PMCID: PMC2594154  PMID: 12392040

Abstract

OBJECTIVE: This study focuses attention on maternal nutrition and stress as possible reasons for excess black infant mortality after exploring lower infant mortality for the infants of foreign-born black mothers compared to native-born black mothers. METHODS: All births to non-Hispanic black women in New York City from 1988-1992 were examined and infant mortality for the infants of native-born women was compared to infant mortality for the infants of foreign-born women. RESULTS: Before controlling for potential confounders on the birth certificate, the infants of native-born black women had a greater risk of infant mortality than the infants of foreign-born black women: OR = 1.48 (95% confidence interval [CI] = 1.38, 1.58). After controlling for potential confounders, the infants of native-born black women still had a greater risk of infant mortality than the infants of foreign-born black women: OR(a) = 1.32 (95% Cl = 1.21, 1.43). CONCLUSIONS: Maternal nutrition and stress are possible causes of excess black infant mortality. They should be topics for research and program development.

Full text

PDF
770

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Berkowitz G. S., Kasl S. V. The role of psychosocial factors in spontaneous preterm delivery. J Psychosom Res. 1983;27(4):283–290. doi: 10.1016/0022-3999(83)90050-8. [DOI] [PubMed] [Google Scholar]
  2. Bogden J. D., Thind I. S., Louria D. B., Caterini H. Maternal and cord blood metal concentrations and low birth weight--a case-control study. Am J Clin Nutr. 1978 Jul;31(7):1181–1187. doi: 10.1093/ajcn/31.7.1181. [DOI] [PubMed] [Google Scholar]
  3. Boyce W. T., Schaefer C., Uitti C. Permanence and change: psychosocial factors in the outcome of adolescent pregnancy. Soc Sci Med. 1985;21(11):1279–1287. doi: 10.1016/0277-9536(85)90278-3. [DOI] [PubMed] [Google Scholar]
  4. Cabral H., Fried L. E., Levenson S., Amaro H., Zuckerman B. Foreign-born and US-born black women: differences in health behaviors and birth outcomes. Am J Public Health. 1990 Jan;80(1):70–72. doi: 10.2105/ajph.80.1.70. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Carmichael S. L., Iyasu S. Changes in the black-white infant mortality gap from 1983 to 1991 in the United States. Am J Prev Med. 1998 Oct;15(3):220–227. doi: 10.1016/s0749-3797(98)00052-x. [DOI] [PubMed] [Google Scholar]
  6. Centers for Disease Control and Prevention (CDC) Differences in infant mortality between blacks and whites--United States, 1980-1991. MMWR Morb Mortal Wkly Rep. 1994 Apr 29;43(16):288–289. [PubMed] [Google Scholar]
  7. Chavkin W., Busner C., Mclaughlin M. Reproductive health: Caribbean women in New York City, 1980-1984. Int Migr Rev. 1987 Fall;21(3):609–625. [PubMed] [Google Scholar]
  8. Chavkin W., St Clair D. Beyond prenatal care: a comprehensive vision of reproductive health. J Am Med Womens Assoc. 1990 Mar-Apr;45(2):55–57. [PubMed] [Google Scholar]
  9. Cohen B. B., Friedman D. J., Mahan C. M., Lederman R., Munoz D. Ethnicity, maternal risk, and birth weight among Hispanics in Massachusetts, 1987-89. Public Health Rep. 1993 May-Jun;108(3):363–371. [PMC free article] [PubMed] [Google Scholar]
  10. Collins J. W., Jr, David R. J. The differential effect of traditional risk factors on infant birthweight among blacks and whites in Chicago. Am J Public Health. 1990 Jun;80(6):679–681. doi: 10.2105/ajph.80.6.679. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Collins J. W., Jr, Shay D. K. Prevalence of low birth weight among Hispanic infants with United States-born and foreign-born mothers: the effect of urban poverty. Am J Epidemiol. 1994 Jan 15;139(2):184–192. doi: 10.1093/oxfordjournals.aje.a116980. [DOI] [PubMed] [Google Scholar]
  12. Collins N. L., Dunkel-Schetter C., Lobel M., Scrimshaw S. C. Social support in pregnancy: psychosocial correlates of birth outcomes and postpartum depression. J Pers Soc Psychol. 1993 Dec;65(6):1243–1258. doi: 10.1037//0022-3514.65.6.1243. [DOI] [PubMed] [Google Scholar]
  13. David R. J., Collins J. W., Jr Differing birth weight among infants of U.S.-born blacks, African-born blacks, and U.S.-born whites. N Engl J Med. 1997 Oct 23;337(17):1209–1214. doi: 10.1056/NEJM199710233371706. [DOI] [PubMed] [Google Scholar]
  14. Doucet H., Baumgarten M., Infante-Rivard C. Risk of low birthweight and prematurity among foreign-born mothers. Can J Public Health. 1992 May-Jun;83(3):192–195. [PubMed] [Google Scholar]
  15. Edwards C. H., Cole O. J., Oyemade U. J., Knight E. M., Johnson A. A., Westney O. E., Laryea H., West W., Jones S., Westney L. S. Maternal stress and pregnancy outcomes in a prenatal clinic population. J Nutr. 1994 Jun;124(6 Suppl):1006S–1021S. doi: 10.1093/jn/124.suppl_6.1006S. [DOI] [PubMed] [Google Scholar]
  16. Friedman D. J., Cohen B. B., Mahan C. M., Lederman R. I., Vezina R. J., Dunn V. H. Maternal ethnicity and birthweight among blacks. Ethn Dis. 1993 Summer;3(3):255–269. [PubMed] [Google Scholar]
  17. Goldenberg R. L., Tamura T., Neggers Y., Copper R. L., Johnston K. E., DuBard M. B., Hauth J. C. The effect of zinc supplementation on pregnancy outcome. JAMA. 1995 Aug 9;274(6):463–468. doi: 10.1001/jama.1995.03530060037030. [DOI] [PubMed] [Google Scholar]
  18. Guendelman S., Abrams B. Dietary intake among Mexican-American women: generational differences and a comparison with white non-Hispanic women. Am J Public Health. 1995 Jan;85(1):20–25. doi: 10.2105/ajph.85.1.20. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Guendelman S., English P. B. Effect of United States residence on birth outcomes among Mexican immigrants: an exploratory study. Am J Epidemiol. 1995 Nov 1;142(9 Suppl):S30–S38. doi: 10.1093/aje/142.supplement_9.s30. [DOI] [PubMed] [Google Scholar]
  20. Guendelman S., Gould J. B., Hudes M., Eskenazi B. Generational differences in perinatal health among the Mexican American population: findings from HHANES 1982-84. Am J Public Health. 1990 Dec;80 (Suppl):61–65. doi: 10.2105/ajph.80.suppl.61. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Hamvas A., Wise P. H., Yang R. K., Wampler N. S., Noguchi A., Maurer M. M., Walentik C. A., Schramm W. F., Cole F. S. The influence of the wider use of surfactant therapy on neonatal mortality among blacks and whites. N Engl J Med. 1996 Jun 20;334(25):1635–1640. doi: 10.1056/NEJM199606203342504. [DOI] [PubMed] [Google Scholar]
  22. Hedegaard M., Henriksen T. B., Secher N. J., Hatch M. C., Sabroe S. Do stressful life events affect duration of gestation and risk of preterm delivery? Epidemiology. 1996 Jul;7(4):339–345. doi: 10.1097/00001648-199607000-00001. [DOI] [PubMed] [Google Scholar]
  23. Hogue C. J., Hargraves M. A. Preterm birth in the African-American community. Semin Perinatol. 1995 Aug;19(4):255–262. doi: 10.1016/s0146-0005(05)80039-4. [DOI] [PubMed] [Google Scholar]
  24. Hyman I., Dussault G. The effect of acculturation on low birthweight in immigrant women. Can J Public Health. 1996 May-Jun;87(3):158–162. [PubMed] [Google Scholar]
  25. Istvan J. Stress, anxiety, and birth outcomes: a critical review of the evidence. Psychol Bull. 1986 Nov;100(3):331–348. [PubMed] [Google Scholar]
  26. Kessel S. S., Villar J., Berendes H. W., Nugent R. P. The changing pattern of low birth weight in the United States--1970 to 1980. JAMA. 1984 Apr 20;251(15):1978–1982. [PubMed] [Google Scholar]
  27. Kleinman J. C., Fingerhut L. A., Prager K. Differences in infant mortality by race, nativity status, and other maternal characteristics. Am J Dis Child. 1991 Feb;145(2):194–199. doi: 10.1001/archpedi.1991.02160020086023. [DOI] [PubMed] [Google Scholar]
  28. Kleinman J. C. Infant mortality among racial/ethnic minority groups, 1983-1984. MMWR CDC Surveill Summ. 1990 Jul;39(3):31–39. [PubMed] [Google Scholar]
  29. Kleinman J. C., Kessel S. S. Racial differences in low birth weight. Trends and risk factors. N Engl J Med. 1987 Sep 17;317(12):749–753. doi: 10.1056/NEJM198709173171207. [DOI] [PubMed] [Google Scholar]
  30. Lenders C. M., Hediger M. L., Scholl T. O., Khoo C. S., Slap G. B., Stallings V. A. Effect of high-sugar intake by low-income pregnant adolescents on infant birth weight. J Adolesc Health. 1994 Nov;15(7):596–602. doi: 10.1016/1054-139x(94)90145-s. [DOI] [PubMed] [Google Scholar]
  31. Lobel M. Conceptualizations, measurement, and effects of prenatal maternal stress on birth outcomes. J Behav Med. 1994 Jun;17(3):225–272. doi: 10.1007/BF01857952. [DOI] [PubMed] [Google Scholar]
  32. Lobel M., Dunkel-Schetter C., Scrimshaw S. C. Prenatal maternal stress and prematurity: a prospective study of socioeconomically disadvantaged women. Health Psychol. 1992;11(1):32–40. doi: 10.1037//0278-6133.11.1.32. [DOI] [PubMed] [Google Scholar]
  33. Lumey L. H., Stein A. D. In utero exposure to famine and subsequent fertility: The Dutch Famine Birth Cohort Study. Am J Public Health. 1997 Dec;87(12):1962–1966. doi: 10.2105/ajph.87.12.1962. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Mangold W. D., Powell-Griner E. Race of parents and infant birthweight in the United States. Soc Biol. 1991 Spring-Summer;38(1-2):13–27. doi: 10.1080/19485565.1991.9988770. [DOI] [PubMed] [Google Scholar]
  35. Marmot M. G., Adelstein A. M., Bulusu L. Lessons from the study of immigrant mortality. Lancet. 1984 Jun 30;1(8392):1455–1457. doi: 10.1016/s0140-6736(84)91943-3. [DOI] [PubMed] [Google Scholar]
  36. McAnarney E. R., Stevens-Simon C. Maternal psychological stress/depression and low birth weight. Is there a relationship? Am J Dis Child. 1990 Jul;144(7):789–792. doi: 10.1001/archpedi.1990.02150310057027. [DOI] [PubMed] [Google Scholar]
  37. McGrady G. A., Sung J. F., Rowley D. L., Hogue C. J. Preterm delivery and low birth weight among first-born infants of black and white college graduates. Am J Epidemiol. 1992 Aug 1;136(3):266–276. doi: 10.1093/oxfordjournals.aje.a116492. [DOI] [PubMed] [Google Scholar]
  38. McLean D. E., Hatfield-Timajchy K., Wingo P. A., Floyd R. L. Psychosocial measurement: implications for the study of preterm delivery in black women. Am J Prev Med. 1993 Nov-Dec;9(6 Suppl):39–81. [PubMed] [Google Scholar]
  39. Neggers Y. H., Cutter G. R., Acton R. T., Alvarez J. O., Bonner J. L., Goldenberg R. L., Go R. C., Roseman J. M. A positive association between maternal serum zinc concentration and birth weight. Am J Clin Nutr. 1990 Apr;51(4):678–684. doi: 10.1093/ajcn/51.4.678. [DOI] [PubMed] [Google Scholar]
  40. Newton R. W., Webster P. A., Binu P. S., Maskrey N., Phillips A. B. Psychosocial stress in pregnancy and its relation to the onset of premature labour. Br Med J. 1979 Aug 18;2(6187):411–413. doi: 10.1136/bmj.2.6187.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Norbeck J. S., DeJoseph J. F., Smith R. T. A randomized trial of an empirically-derived social support intervention to prevent low birthweight among African American women. Soc Sci Med. 1996 Sep;43(6):947–954. doi: 10.1016/0277-9536(96)00003-2. [DOI] [PubMed] [Google Scholar]
  42. Oakley A. Social support in pregnancy: the 'soft' way to increase birthweight? Soc Sci Med. 1985;21(11):1259–1268. doi: 10.1016/0277-9536(85)90275-8. [DOI] [PubMed] [Google Scholar]
  43. Polednak A. P. Black-white differences in infant mortality in 38 standard metropolitan statistical areas. Am J Public Health. 1991 Nov;81(11):1480–1482. doi: 10.2105/ajph.81.11.1480. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Sandman C. A., Wadhwa P. D., Chicz-DeMet A., Dunkel-Schetter C., Porto M. Maternal stress, HPA activity, and fetal/infant outcome. Ann N Y Acad Sci. 1997 Apr 24;814:266–275. doi: 10.1111/j.1749-6632.1997.tb46162.x. [DOI] [PubMed] [Google Scholar]
  45. Schoendorf K. C., Hogue C. J., Kleinman J. C., Rowley D. Mortality among infants of black as compared with white college-educated parents. N Engl J Med. 1992 Jun 4;326(23):1522–1526. doi: 10.1056/NEJM199206043262303. [DOI] [PubMed] [Google Scholar]
  46. Scholl T. O., Hediger M. L., Fischer R. L., Shearer J. W. Anemia vs iron deficiency: increased risk of preterm delivery in a prospective study. Am J Clin Nutr. 1992 May;55(5):985–988. doi: 10.1093/ajcn/55.5.985. [DOI] [PubMed] [Google Scholar]
  47. Scholl T. O., Hediger M. L., Schall J. I., Fischer R. L., Khoo C. S. Low zinc intake during pregnancy: its association with preterm and very preterm delivery. Am J Epidemiol. 1993 May 15;137(10):1115–1124. doi: 10.1093/oxfordjournals.aje.a116615. [DOI] [PubMed] [Google Scholar]
  48. Scribner R., Dwyer J. H. Acculturation and low birthweight among Latinos in the Hispanic HANES. Am J Public Health. 1989 Sep;79(9):1263–1267. doi: 10.2105/ajph.79.9.1263. [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Singh G. K., Yu S. M. Adverse pregnancy outcomes: differences between US- and foreign-born women in major US racial and ethnic groups. Am J Public Health. 1996 Jun;86(6):837–843. doi: 10.2105/ajph.86.6.837. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Singh G. K., Yu S. M. Infant mortality in the United States: trends, differentials, and projections, 1950 through 2010. Am J Public Health. 1995 Jul;85(7):957–964. doi: 10.2105/ajph.85.7.957. [DOI] [PMC free article] [PubMed] [Google Scholar]
  51. Singh G. K., Yu S. M. Infant mortality in the United States: trends, differentials, and projections, 1950 through 2010. Am J Public Health. 1995 Jul;85(7):957–964. doi: 10.2105/ajph.85.7.957. [DOI] [PMC free article] [PubMed] [Google Scholar]
  52. THOMSON A. M. Technique and perspective in clinical and dietary studies of human pregnancy. Proc Nutr Soc. 1957;16(1):45–51. doi: 10.1079/pns19570011. [DOI] [PubMed] [Google Scholar]
  53. Terry P. B., Condie R. G., Bissenden J. G., Kerridge D. F. Ethnic differences in incidence of very low birthweight and neonatal deaths among normally formed infants. Arch Dis Child. 1987 Jul;62(7):709–711. doi: 10.1136/adc.62.7.709. [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. Valanis B. M., Rush D. A partial explanation of superior birth weights among foreign-born women. Soc Biol. 1979 Fall;26(3):198–210. doi: 10.1080/19485565.1979.9988378. [DOI] [PubMed] [Google Scholar]
  55. Wadhwa P. D., Dunkel-Schetter C., Chicz-DeMet A., Porto M., Sandman C. A. Prenatal psychosocial factors and the neuroendocrine axis in human pregnancy. Psychosom Med. 1996 Sep-Oct;58(5):432–446. doi: 10.1097/00006842-199609000-00006. [DOI] [PubMed] [Google Scholar]
  56. Wadhwa P. D., Porto M., Garite T. J., Chicz-DeMet A., Sandman C. A. Maternal corticotropin-releasing hormone levels in the early third trimester predict length of gestation in human pregnancy. Am J Obstet Gynecol. 1998 Oct;179(4):1079–1085. doi: 10.1016/s0002-9378(98)70219-4. [DOI] [PubMed] [Google Scholar]
  57. Wadhwa P. D., Sandman C. A., Porto M., Dunkel-Schetter C., Garite T. J. The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigation. Am J Obstet Gynecol. 1993 Oct;169(4):858–865. doi: 10.1016/0002-9378(93)90016-c. [DOI] [PubMed] [Google Scholar]
  58. Wilcox M., Gardosi J., Mongelli M., Ray C., Johnson I. Birth weight from pregnancies dated by ultrasonography in a multicultural British population. BMJ. 1993 Sep 4;307(6904):588–591. doi: 10.1136/bmj.307.6904.588. [DOI] [PMC free article] [PubMed] [Google Scholar]
  59. Williams R. L., Binkin N. J., Clingman E. J. Pregnancy outcomes among Spanish-surname women in California. Am J Public Health. 1986 Apr;76(4):387–391. doi: 10.2105/ajph.76.4.387. [DOI] [PMC free article] [PubMed] [Google Scholar]
  60. Wise P. H., Wampler N., Barfield W. The importance of extreme prematurity and low birthweight to US neonatal mortality patterns: implications for prenatal care and women's health. J Am Med Womens Assoc. 1995 Sep-Oct;50(5):152–155. [PubMed] [Google Scholar]
  61. Zhou L. M., Yang W. W., Hua J. Z., Deng C. Q., Tao X., Stoltzfus R. J. Relation of hemoglobin measured at different times in pregnancy to preterm birth and low birth weight in Shanghai, China. Am J Epidemiol. 1998 Nov 15;148(10):998–1006. doi: 10.1093/oxfordjournals.aje.a009577. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES