Background: The macro-level economy may affect fetal health through maternal behavioral or physiologic responses.
Methods: We used a multilevel design to examine associations between exposure to state-level unexpected economic contraction during each trimester of gestation and birth weight for gestational age percentile and small for gestational age (SGA), using the National Longitudinal Survey of Youth 1979. We examined differences in observed associations by maternal educational attainment, race/ethnicity, employment status, and poverty status.
Results: Exposure in the first trimester was associated with a 3.7 percentile point decrease in birth weight for gestational age (95% confidence interval [CI] = −6.8 to −0.6). This association appeared stronger for women “keeping house” or with <12 years education. Exposure in the first trimester was also associated with increased odds of SGA (odds ratio = 1.5 [95% CI = 1.1 to 2.1]) and term SGA (odds ratio = 1.6 [95% CI = 1.2 to 2.3]).
Conclusions: Unexpected economic contraction during early pregnancy may be associated with reduced fetal growth.
From the Divisions of aEpidemiology and bBiostatistics, School of Public Health, University of California Berkeley, Berkeley, CA.
Submitted 26 October 2011; accepted 14 June 2011; posted 7 September 2011.
Supported by Robert Wood Johnson Foundation Health and Society Scholars Program.
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Correspondence: Claire E. Margerison-Zilko, 11 University Hall, School of Public Health, University of California, Berkeley, CA 94720. E-mail: firstname.lastname@example.org.