Racial disparities in birth outcomes increase with maternal age: recent data from North Carolina.

BACKGROUND Racial disparities in birth outcomes persist in North Carolina and the United States. We examined patterns of birth outcomes and womens health measures in North Carolina by race and age to portray the largest disparities. We wanted to see if our data were consistent with the "weathering hypothesis," which holds that the health of African American women may begin to deteriorate in early adulthood, with negative effects on birth outcomes. METHODS We conducted a descriptive analysis of 1999-2003 North Carolina live birth and infant death records and 2001-2003 Behavioral Risk Factor Surveillance System survey data. Birth outcome measures examined were low birth weight, very low birth weight, infant mortality neonatal mortality and postneonatal mortality. Womens health measures examined were obesity self-reported health status, high blood pressure, high cholesterol, current smoking, and smoking during pregnancy. Rates for whites and African Americans were compared for each of three age groups. RESULTS Racial disparities in birth outcomes increase with increasing maternal age. African American teens often experience better birth outcomes than older African American women. Racial disparities in measures of womens health also increase with increasing age. CONCLUSIONS Health problems among older African American women of reproductive age may contribute substantially to racial disparities in birth outcomes. Improving the health of older African American women may be an effective strategy to reduce the overall racial disparities in birth outcomes.