Racial-Ethnic Disparities in Low Birthweight: A Multi Level Study in LA County

Project Number: R40 MC 06635-03
Project Date: 01/01/2006
Grantee: The Regents of the University of California
Department/Center: David Geffen School of Medicine at UCLA

Final Report

Pending

Principal Investigator

Michael C. Lu M.D.,
Assistant Professor, The Regents of the University of California David Geffen School of Medicine at UCLA,
27-239 CHS Box 951740
Los Angeles, CA 90095-1740
mclu@ucla.edu

Abstract

Low birth weight (LBW) is a leading cause of racial-ethnic disparities in perinatal mortality and morbidities in the US and in Los Angeles County (LAC). The reasons for the persisting disparities in LBW are largely unknown. We hypothesize that racial ethnic disparities in LBW are mediated in large part by pregnancy and lifetime exposures to interpersonal and institutionalized racism, acting directly on maternal stress biology and behavior or indirectly through family, neighborhood and institutional stressors. The effects of racism are moderated by social support and cultural factors. To test this hypothesis, we propose a multilevel study using the Los Angeles Mommy and Baby Survey (LAMBS). The LAMBS will survey 3,130 mothers in LAC with a recent live birth using a mixed-mode methodology similar to the Pregnancy Risk Assessment Monitoring System (PRAMS). However, LAMBS differs from PRAMS in two important ways. First, LAMBS is based on a multistage clustered design, first sampling neighborhoods (90 "high-risk" and 45 "low-risk" neighborhoods), and then sampling births within these neighborhoods with over-sampling of LBW births. Second, LAMBS is designed as a multilevel survey, assessing not only individual-level factors but also interpersonal, neighborhood, and institutional influences including racism. The LAMBS' multistage clustered sampling and expanded questionnaire will allow for multilevel analysis of the multiple determinants of racial-ethnic disparities in LBW.

Publications

Pending

Keywords

Low birthweight Preterm birth Pregnant women Surveys