Trends in infants born at low birthweight and disparities by maternal race and education from 2003 to 2018 in the United States

Background Understanding current levels, as well as past and future trends, of the percentage of infants born at low birthweight (LBW) in the United States is imperative to improving the health of our nation. The purpose of this study, therefore, was to examine recent trends in percentage of LBW, both overall and by maternal race and education subgroups. Studying disparities in percentage of LBW by these subgroups can help to further understand the health needs of the population and can inform policies that can close race and class disparities in poor birth outcomes. Methods Trends of percentage of LBW in the U.S. from 2003 to 2018, both overall and by race/ethnicity, and from 2007 to 2018 by education and race by education subgroups were analyzed using CDC WONDER Natality data. Disparities were analyzed using between group variance methods. Results Percentage of LBW experienced a significant worsening in the most recent 5 years of data, negating nearly a decade of prior improvement. Stark differences were observed by race/ethnicity and by education, with all subgroups experiencing increasing rates in recent years. Disparities also worsened over the course of study. Most notably, all disparities increased significantly from 2014 to 2018, with annual changes near 2-5%. Conclusions Recent reversals in progress in percentage of LBW, as well as increasing disparities particularly by race, are troubling. Future study is needed to continue monitoring these trends and analyzing these issues at additional levels. Targets must be set and solutions must be tailored to population subgroups to effectively make progress towards equitable birth outcomes and maternal health.

Automated summary

Recent trends in percentage of low birthweight (LBW) infants in the United States have shown significant worsening, especially in the past five years, negating nearly a decade of prior improvement. Stark differences by race/ethnicity and education level have been observed, with all subgroups experiencing increasing rates in recent years. Disparities in poor birth outcomes have also worsened over the course of study, with all disparities increasing significantly from 2014 to 2018. Further research is needed to monitor and analyze these trends at additional levels in order to tailor solutions for equitable birth outcomes and maternal health.