James W. Collins, MD¹, Dyan Simon, MD¹, and Aimee Drolet, PhD². (1) Pediatrics/Neonatology, Northwestern University/Children's Memorial Hospital, 2300 Children's Plaza, Box 45, Chicago, IL 60614, 773-880-4142, jcollins@northwestern.edu, (2) The Anderson School, UCLA, Box 951481, B406 Gold Hall, Los Angeles, CA 90095-1481

OBJECTIVE. To determine the extent to which neighborhood poverty modifies the risk of LBW associated with advanced maternal age among urban African-Americans.

DESIGN/METHODS. We performed stratified and multivariate logistic analyses on a linked dataset of 1992-1995 Illinois vital records, 1990 US census income data, and 1995 Chicago Department of Public Health information. Neighborhoods with four high-risk characteristics (low median family income, high rates of unemployment, homicide, and lead poisoning) were classified as extremely impoverished. Neighborhoods with zero high-risk characteristics were classified as non-impoverished.

RESULTS. In Chicago, 21% (N=21,811) of African-American infants were born to mothers who resided in non-impoverished neighborhoods. Startlingly, 23% (N=24,914) of African-American infants were born to mothers who lived in extremely impoverished neighborhoods. In non-impoverished neighborhoods, 35-39 year old women had an infant LBW rate of 18% compared to 13% for 20-24 year old women; RR=1.4 (1.2-1.6) and risk difference = 5.8% (2.5-8.3). In extremely impoverished neighborhoods, 35-39 year old women had an infant LBW rate of 30% compared to 14% for 20-24 year old women; RR= 2.1(1.9-2.3) and risk difference = 15% (12.7-17.4). This trend occurred independent of maternal education, marital status, and prenatal care usage. The same phenomenon occurred among primagravids.

CONCLUSIONS. We conclude that neighborhood poverty increases the reproductive risk of advanced maternal age among urban African-American women. This finding highlights a “weathering” phenomenon among African-American women and strongly suggests that neighborhood factors contribute to the racial disparity in infant birth weight.

Learning Objectives:

• To understand the relationship between advancing maternal age and infant low birth weight among urban African-Americans.
• To understand that neighborhood poverty compounds the effect of advancing maternal age on infant low birth weight among urban African-Americans.

Keywords: Birth Outcomes, Minority Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.