Document Detail

Maternal education, birth weight, and infant mortality in the United States.
MedLine Citation:
PMID:  23073749     Owner:  NLM     Status:  MEDLINE    
This research determines whether the observed decline in infant mortality with socioeconomic level, operationalized as maternal education (dichotomized as college or more, versus high school or less), is due to its "indirect" effect (operating through birth weight) and/or to its "direct" effect (independent of birth weight). The data used are the 2001 U.S. national African American, Mexican American, and European American birth cohorts by sex. The analysis explores the birth outcomes of infants undergoing normal and compromised fetal development separately by using covariate density defined mixture of logistic regressions (CDDmlr). Among normal births, mean birth weight increases significantly (by 27-108 g) with higher maternal education. Mortality declines significantly (by a factor of 0.40-0.96) through the direct effect of education. The indirect effect of education among normal births is small but significant in three cohorts. Furthermore, the indirect effect of maternal education tends to increase mortality despite improved birth weight. Among compromised births, education has small and inconsistent effects on birth weight and infant mortality. Overall, our results are consistent with the view that the decrease in infant death by socioeconomic level is not mediated by improved birth weight. Interventions targeting birth weight may not result in lower infant mortality.
Timothy B Gage; Fu Fang; Erin O'Neill; Greg Dirienzo
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Demography     Volume:  50     ISSN:  0070-3370     ISO Abbreviation:  Demography     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-22     Completed Date:  2013-07-12     Revised Date:  2014-04-02    
Medline Journal Info:
Nlm Unique ID:  0226703     Medline TA:  Demography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  615-35     Citation Subset:  IM    
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MeSH Terms
African Americans / statistics & numerical data
Birth Weight*
Educational Status*
European Continental Ancestry Group / statistics & numerical data
Infant Mortality / trends*
Infant, Newborn
Logistic Models
Mexican Americans / statistics & numerical data
Socioeconomic Factors
United States / epidemiology
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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