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October 1999-HRSA/MCHB Supported Research Explores the Link Between a Mother's Birth-Weight and the Risk of Pre-term Delivery and Low-Birth Weight in Her Own Pregnancies

A large population-based inter-generational database that links vital statistics, hospital obstetrical and neonatal discharge summaries and motor vehicle licencing information is exploring birth characteristics across generations under the support of a HRSA/MCHB research grant. Two articles based on this unique database were published in 1999 under the authorship of Irvin Emanuel, M.D. and colleagues from the University of Washington, Seattle. The two articles, The Washington State Inter-generational Study of Birth Outcomes: Methdology and Some Comparisons of Maternal Birth-weight and Infant Birth-weight and Gestion in Four Race/ethnic Groups, and, A Population-based Cohort Study of the Relation Between Maternal Birth-weight and Risk of Gestational Diabetes Mellitus in Four Racial/ethnic Groups, have been published in the British journal Paediatric and Perinatal Epidemiology (1999, 13, 352-371 & 13, 670-682). An additional third article, Respiratory Distress Syndrome and Maternal Birth Weight Effects, will appear in the U.S. journal Obstetrics and Gynecology as part of one of the journal's year 2000 issues. All three articles are noted for their racial- and ethnic-specific analyses and are representative of cutting-edge research that seeks to elucidate the pre-natal, fetal and natal antecedents of adult-onset diseases such as hypertension, gestational and adult onset diabetes. Study 1 presents data supportive of an inverse dose-response association between maternal birth weight and four adverse infant outcomes: low birth-weight, very low birth-weight, pre-term birth and very pre-term birth. Besides the association between maternal birth-weight and adverse outcomes, the most important findings of the study concern the pattern of risks and outcomes found among the four race/ethnic groups studied (i.e., non-Hispanic whites, Hispanics, African-American and Native American). In general, non-Hispanic whites had lowest rates of adverse birth outcomes and African-Americans had the highest. But maternal birth-weight was an important mediator of adverse outcomes in each of the four groups. Study 2 looked at the association between what a mothers weight when she is born (i.e., maternal birth weight) and the risk of developing gestational diabetes mellitus (GDM) later in life. Women who develop GDM, a relatively common maternal medical complication of pregnancy, are thought to have a compromised physiological capacity to adapt to the metabolic challenges of late pregnancy. Findings from Study 2 indicate that maternal birth-weight of 2000 grams or less is associated with an almost doubling in the risk for GDM among non-Hispanic white, African American, Native American and Hispanic women. African-American women with a birth-weight of 4000 grams or more also experienced a two-fold increased risk of GDM.

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