Neighborhood influences on the association between maternal age and birthweight: A multilevel investigation of age-related disparities in health

It was hypothesized that the relationship between maternal age and infant birthweight varies significantly across neighborhoods and that such variation can be predicted by neighborhood characteristics. We analyzed 229,613 singleton births of mothers aged 20–45 years from Chicago, USA in 1997–2002. Random coefficient models were used to estimate the between-neighborhood variation in age–birthweight slopes, and both intercepts- and-slopes-as-outcomes models were used to evaluate area-level predictors of such variation. The crude maternal age–birthweight slopes for neighborhoods ranged from a decrease of 17 g to an increase of 10 g per year of maternal age. Adjustment for individual-level covariates reduced but did not eliminate this between-neighborhood variation. Concentrated poverty was a significant neighborhood-level predictor of the age–birthweight slope, explaining 44.4% of the between-neighborhood variation in slopes. Neighborhoods of higher economic disadvantage showed a more negative age–birthweight slope. The findings support the hypothesis that the relationship between maternal age and birthweight varies between neighborhoods. Indicators of neighborhood disadvantage help to explain such differences.