Background Studies have shown that the birth weight of infantsis correlated with the birth weights of their siblings and theirmothers. We investigated whether the birth weights of mothersand index children were jointly associated with the risk oflow birth weight in the siblings of the index children.
Methods We used data on the live-birth cohort of the 1988 NationalMaternal and Infant Health Survey. The analysis included 1691white and 1461 black mothers, each of whom had two or more live-born,singleton children. Multiple logistic regression with generalized-estimationequations was used to assess the risk of low birth weight amongan index child's siblings. Four groups were studied: that inwhich neither the mother nor the index child had low birth weight(group 1), that in which only the mother had low birth weight(group 2), that in which only the index child had low birthweight (group 3), and that in which both the mother and theindex child had low birth weight (group 4). There was adjustmentfor other maternal and infant covariates.
Results In groups 1, 2, 3, and 4, respectively, 3.6, 8.3, 21.2,and 38.9 percent of white siblings had low birth weights, ascompared with 8.0, 19.0, 31.1, and 57.1 percent of black siblings.When group 1 was used as the reference group, the adjusted oddsratios (and 95 percent confidence intervals) for low birth weightin groups 2, 3, and 4 were 2.5 (1.4 to 4.3), 6.8 (4.7 to 9.8),and 15.4 (9.2 to 25.5), respectively, among white siblings and2.6 (1.8 to 3.8), 4.7 (3.5 to 6.4), and 13.9 (9.2 to 20.9) amongblack siblings. These associations were consistently found forbirth weights below 1500 g and those ranging from 1500 to 2499g in both races and after stratification for the mother's age,parity, education, cigarette-smoking status, and weight andheight before pregnancy and the infant's sex.
Conclusions Although the possibility of selection and recallbiases cannot be excluded with certainty, our data suggest astrong familial aggregation of low birth weight among both whitesand blacks in the United States.
Source Information
From the Department of Pediatrics, Boston University School of Medicine and Boston City Hospital (X.W., B.Z., M.J.C.), and the Boston University School of Public Health (G.A.C.) both in Boston.
Address reprint requests to Dr. Wang at the Department of Pediatrics, Boston University School of Medicine, 818 Harrison Ave., Boston, MA 02118.
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