An Integrative Model of Inter- and Intragenerational Preconception Processes Influencing Birthweight in the United States

Abstract

Social inequalities in birth weight are an important population health concern as low birth weight is one mechanism through which inequalities are reproduced across generations. Yet we don’t understand what causes adverse birth outcomes. This study draws together theoretic and empiric findings from disparate disciplines—sociology, economics, public health, and behavior genetics—to develop a new integrative intra- and inter-generational model of preconception processes influencing birth weight. This model is empirically tested using structural equation modeling and population-level data containing linked mother-daughter pairs from the National Longitudinal Survey of Youth (NLSY79) and the Children of the NLSY79 (N=1,580 mother-daughter pairs). Results reveal that birth weight is shaped by preconception factors dating back to women’s early life experiences as well as conditions dating back three generations, via integrative intra- and inter-generational processes. These processes reveal specific mechanisms through which social inequality can transmit from mothers to children via birth weight.

Theoretical Insights into Preconception Social Conditions and Perinatal Health: The Role of Place and Social Relationships

“…We focus our attention on place and social relationships because these have received relatively less attention in the literature. [See, for example, these studies examining childhood poverty/parental SES on perinatal health risk: (Harville, Boynton-Jarrett et al 2010, Gavin, Hill et al 2011, Harville, Madkour et al 2012, Kane 2015, Margerison-Zilko, Strutz et al 2016)]. In doing so, this paper contributes a stronger theoretical foundation to this literature that can reinvigorate research on the preconception predictors of adverse birth outcomes; it also contributes greater cohesion to the extant research on preconception social conditions.…”

“…One set of studies examine similarities between mothers' and daughters' birth weight outcomes, and the social processes—such as maternal income—mediating this association (Conley and Bennett 2000, Conley and Bennett 2001, Currie and Moretti 2003, Currie and Moretti 2007). Other studies identify risk factors and pathways of risk contributing to poor perinatal health that date back multiple generations, such as intergenerational transmissions of low maternal education (Kane 2015, McFarland, McLanahan et al In press). …”

“…Indeed, understanding not only the mother's early life course experiences through a more comprehensive lens of place and social relationships, but also understanding the experiences of her parents, which may have critically shaped her early life experiences, could lend a more comprehensive understanding of the set of risk factors leading to poor perinatal health. As previously noted, prior studies have laid the groundwork for exploring these associations (Conley and Bennett 2000, Conley and Bennett 2001, Currie and Moretti 2003, Currie and Moretti 2007, Kane 2015, McFarland, McLanahan et al In press), but much more work is needed to parse out these socially and biologically complex pathways. Furthermore, such explorations could expand our understanding of infant health as a mechanism transmitting social, health, and economic, disadvantage from one generation to the next (Case, Lubotsky et al 2002, Case and Paxson 2006, Kane 2015, Kane 2016).…”

“…As previously noted, prior studies have laid the groundwork for exploring these associations (Conley and Bennett 2000, Conley and Bennett 2001, Currie and Moretti 2003, Currie and Moretti 2007, Kane 2015, McFarland, McLanahan et al In press), but much more work is needed to parse out these socially and biologically complex pathways. Furthermore, such explorations could expand our understanding of infant health as a mechanism transmitting social, health, and economic, disadvantage from one generation to the next (Case, Lubotsky et al 2002, Case and Paxson 2006, Kane 2015, Kane 2016). This topic holds particular significance in the field of population health, given that the very nature of this intergenerational transmission implies that improving infant health for all and reducing racial and social class disparities in infant health could have dramatic implications not only for the health and well-being of future generations but also for population-level patterns of racial and social inequality.…”

Grandparents' Education and Infant Health: Pathways Across Generations

“…Second, although the small body of literature that directly examines the relationship between grandparent's SES and infant health cannot provide many definitive answers because of varying samples, study designs, and measures of SES, three tentative conclusions can be reached. Mothers from disadvantaged backgrounds in childhood tend to have children with lower birth weight when compared with their more advantaged counterparts (Astone, Misra, & Lynch, ; Gavin, Hill, Hawkins, & Maas, ; Gavin, Thompson, Rue, & Gou, ; Kane, ). Mother's adult SES and marital status operate as pathways connecting early life experiences to birth outcomes (Gavin et al, , ; Kane, ).…”