Low Birth Weight Racial Disparity in Virginia

Virginia

Low birth weight infants (infants weighing less than 2,500 grams at birth) are at increased risk of several short- and long-term complications. Low birth weight and preterm birth are both leading causes of infant mortality. 

Significant and persistent racial and ethnic differences exist in birth outcomes such as low birth weight, preterm birth and infant mortality. Socioeconomic status does not solely explain racial differences in low birth weight, as rates are higher among Black women even after controlling for socioeconomic status. 

Research has shown that higher lifetime exposure to chronic stressors increases the risk for poor pregnancy outcomes among Black women. Racial discrimination may reduce access to protective clinical and social resources such as adequate prenatal care, employment, educational opportunities and stable housing. Experiencing a lack of social support, psychosocial stress, or unsafe and unhealthy environments at any time in a woman’s life, especially in the period leading up to pregnancy, may independently or collectively contribute to adverse birth outcomes. 

According to America’s Health Rankings analysis, the percentage of infants born with low birth weight is more than two times higher among non-Hispanic Black women, who have the highest prevalence, compared with non-Hispanic white women, who have the lowest prevalence.

Key strategies for reducing the incidence of low birth weight and related preterm birth complications include:

• Ensuring pregnant women have access to early, comprehensive prenatal care, which allows providers to screen for chronic conditions, assess nutritional and psychosocial needs, manage infection risks and deliver preventive interventions.
• Ensuring pregnant women have access to balanced nutrition to achieve healthy gestational weight gain, which is critical for fetal development. Pregnant women should also avoid using alcohol, tobacco and illicit drugs during the duration of their pregnancy.
• Expanding doula services.
• Minimizing exposure to extreme heat and air pollutants, such as fine particulate matter.

Health professionals can implement initiatives to reduce the racial disparity in premature births, such as prenatal care groups located in neighborhood clinics, which aim to provide primary health care and social support for Black pregnant women. Other programs, like the Health Resources and Services Administration's Healthy Start Initiative, focus broadly on providing education, emotional support, access to high-quality health services and comprehensive care during pregnancy and the postpartum period, tailored to the unique needs of Black women. 

Various federal programs exist to support women's needs outside of doctors’ offices, like financial, housing and nutrition assistance. Participation in WIC — a supplemental nutrition program for women, infants and children — is associated with higher birth weight and higher breastfeeding rates.

Healthy People 2030 has several objectives related to pregnancy and childbirth, including reducing preterm births and reducing infant mortality.

Alhusen, Jeanne L., Kelly M. Bower, Elizabeth Epstein, and Phyllis Sharps. “Racial Discrimination and Adverse Birth Outcomes: An Integrative Review.” Journal of Midwifery & Women’s Health 61, no. 6 (November 2016): 707–20. https://doi.org/10.1111/jmwh.12490.