Determinants of intrauterine growth retardation and other compromised birth outcomes: a comparison of Mexican Americans and non-Hispanic Whites.

This research seeks to determine the extent of variation by race/ethnicity in the prevalence of adverse birth outcomes whether these differentials remain after controlling for a large number of other risk factors and whether the direction and magnitude of the effects differ by type of outcome. We employ a revised system of measurement (based on the Fetal Growth Ratio) and a large nationally representative data set which facilitates estimation of multinomial logistic models. The odds of compromised birth outcomes of all types are much greater among African Americans as compared to both non-Hispanic whites and Mexican Americans even after simultaneous adjustment for a wide range of determinants. The vast majority of all effects are as predicted and importantly magnitude and direction of effects are similar across revised outcome categories. Especially notable are the adverse effects associated with both inadequate and adequate-plus prenatal care and with maternal smoking. The odds of compromised outcomes are significantly reduced for mothers participating in the WIC program but there is virtually no effect of household income or receipt of welfare. (authors)