Preterm Delivery and Low Birth Weight among First-Born Infants of Black and White College Graduates

Reproductive outcomes were investigated in black and white female college graduates, presumed to be of similar socioeconomic status and similar risk profile with respect to environmental factors. Data were gathered by mail survey from graduates(1973–1985) of four Atlanta, Georgia, colleges between February and June 1988. Of 6, 867 alumnae to whom questionnaires were mailed, 3,084 responded. A follow-up study of black nonrespondents yielded responses from 14%(335) of those who did not respond to the mail survey. For all graduates with a first live born at the time of survey (n = 1, 089), the rates of preterm delivery, low birth weight, and infant mortality were 80.8, 82.6, and 14.6 per thousand births (primigravlda), respectively. Compared with white graduates, black graduates had 1.67 times the risk of preterm delivery and 2.48 times the risk of low birth weight. Measures of social and economic status differed significantly by race. However, adjustment for these variables did not reduce the estimated risk for black graduates compared with whites. Analysis of the nonresponder survey suggested that respondent data alone overestimates the incidence of adverse outcomes in blacks; using nonresponder data, relative risks of 1.28 (preterm delivery) and 1.75 (low birth weight) were calculated as lower limits of the increased risk for blacks. Am J Epidemiol 1992; 136: 266–76