Maternal Education, Birth Weight, and Infant Mortality in the United States

Author:

Gage Timothy B.12,Fang Fu1,O’Neill Erin1,DiRienzo Greg2

Affiliation:

1. AS 114, Department of Anthropology, University at Albany–SUNY, Albany, NY 12222, USA

2. Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Albany, NY 12222, USA

Abstract

Abstract 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.

Publisher

Duke University Press

Subject

Demography

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3. Birth weight and mortality: Causality or confounding?;Basso;American Journal of Epidemiology,2006

4. Birth weight-specific infant mortality, United States, 1960 and 1980;Buehler;Public Health Reports,1987

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