The intergenerational relationship between mother's birthweight, infant birthweight and infant mortality in black and white mothers.

The relationship between the birthweight of white and black mothers and the outcomes of their infants were examined using the 1988 National Maternal and Infant Health Survey. White and black women who were low birthweight themselves were at increased risk of delivering very low birthweight (VLBW), moderately low birthweight (MLBW), extremely preterm and small size for gestational age (SGA) infants. Adjustment for the confounding effects of prepregnant weight and height reduced the risks of all these outcomes slightly, and more substantially reduced the maternal birthweight associated risk of moderately low birthweight among white mothers. There was little effect of maternal birthweight on infant birthweight-specific infant mortality in white mothers; however, black mothers who weighed less than 4 lbs at birth were at significantly increased risk of delivering a normal birthweight infant who subsequently died. Although the risks for the various outcomes associated with low maternal birthweight were not consistently higher in black mothers compared with white mothers, adjustment for prepregnant weight and height had a greater effect in white mothers than in black mothers. We suggest that interventions to reduce the risks for adverse pregnancy outcomes associated with low maternal birthweight should attempt to optimise prepregnant weight and foster child health and growth.