All ETDs from UAB

Advisory Committee Chair

Martha S Wingate

Advisory Committee Members

David J Becker

Leslie A McClure

Julie K Preskitt

Alan Tn Tita

Document Type


Date of Award


Degree Name by School

Doctor of Public Health (DrPH) School of Public Health


Due to the growing trend in interracial marriages in the United States, the issue of birth outcomes to infants born to such couples deserves more attention and examination. The purpose of this population-based, cross-sectional, observational study is to examine the association between interracial couple status and birth outcomes (i.e. low birth weight, very low birth weight, preterm birth, very preterm birth, small for gestational age) among singleton infants delivered in the United States. Interracial couples are defined as those in a relationship who are not of the same race or ethnic designation. Non-Hispanic white, non-Hispanic black, Hispanic, Asian, Chinese, Filipino, Asian Indian, Korean and Vietnamese races and ethnicities were included. The analyses demonstrated that there are indeed significant differences in birth outcomes when comparing interracial couples to endogamous couples, even after controlling for confounders. Certain patterns emerged, such as having either a white or Asian partner was related to better birth outcomes while having a black or Hispanic partner was often related to worse outcomes. There appears to be a within-group heterogeneity that is occurring, and that among groups of white, black, Hispanic, or Asian (and Asian subgroup) mothers, those who have children with a certain race/ethnic group partner are different from those who are partnering within someone from their own race/ethnicity. Adverse birth outcomes are not isolated incidents that are only influenced by the characteristics of the infants' parents. Because so many variables spanning multiple generations are having an influence on the health of parents and their children, it is important to consider the life course perspective and also apply it practically when seeking appropriate approaches, such as program planning or policy initiatives, to address adverse birth outcomes. Research into why certain interracial couple status seems to afford more protection than endogamous couple status (or vice versa) when it comes to birth outcomes utilizing a longitudinal design (i.e. following several generations) rather than a cross-sectional design may be helpful in finding the positive influences that can be translated into programs or policies that can further promote healthy infants.

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