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

Final Report

Racial-Ethnic Disparities in Low Birthweight: A Multi Level Study in LA County Final Report (PDF)


  • Women/Maternal
  • Prenatal
  • Perinatal/Infancy (0-12 months)


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.


Listed is descending order by year published.

Chao SM, Wakeel F, Herman D, Higgins C, Shi L, Chow J, Sun S, Lu MC. The 2007 Los Angeles Mommy and Baby study: a multilevel, population-based study of maternal and infant health in Los Angeles county. Adv Prev Med. 2014;2014:293648.

Coller KM, Chao SM, Lu MC, Strobino D. Unintended births among adult immigrant and U.S.-born Mexican women in the Los Angeles mommy and baby (LAMB) survey. Womens Health Issues. 2014 Jul-Aug;24(4):e365-e372.

DiBari JN, Yu SM, Chao SM, Lu MC. Use of postpartum care: predictors and barriers. J Pregnancy. 2014;2014:530769.

Shi L, Mao Y. Neighborhood social environment and health communication at prepregnancy and maternal stages among caucasian and Asian women: Findings from the Los Angeles mommy and baby survey. Advances in Public Health, vol. 2014, Article ID 573205, 6 pages, 2014.

Wakeel F, Wisk LE, Gee R, Chao SM, Witt WP. The balance between stress and personal capital during pregnancy and the relationship with adverse obstetric outcomes: findings from the 2007 Los Angeles Mommy and Baby (LAMB) study. Arch Womens Ment Health. 2013 Dec;16(6):435-451.

Wakeel F, Witt WP, Wisk LE, Lu MC, Chao SM. Racial and ethnic disparities in personal capital during pregnancy: findings from the 2007 Los Angeles Mommy and Baby (LAMB) study. Matern Child Health J. 2013 Mar 16. [Epub ahead of print] PubMed PMID: .

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