An infant’s weight at birth has been identified as one pathway through which social and health inequalities can transmit across generations, from mothers to children, given that socially marginalized and economically disadvantaged women are at highest risk of having a low birth weight, growth-restricted, or preterm baby, and children born under these conditions often face considerable health, psychosocial, and cognitive challenges as they age. However, we still know very little about what causes adverse perinatal outcomes. Kane will present findings from a series of studies that seek to answer this question. Instead of focusing on risk factors that present during the prenatal period, Kane identifies potential risk factors presenting prior to pregnancy—during the preconception period--that may be instrumental, based on theory from sociology and epidemiology. Kane then will analyze these potential pathways of risk using a variety of statistical approaches including structural equation modeling, instrumental variables regression, and propensity score matching. Findings reveal new insights into various pathways of risk linking women’s (early life) preconception environment (e.g., childhood poverty, adolescent health and social risk behaviors) to her offspring’s perinatal health outcomes. Subsequent findings extend the preconception period back even further to reveal pathways of risk that can be traced back at least three generations. Kane will also describe ongoing efforts to analyze newly geocoded birth certificate record data that will enrich our understanding of how these processes operate through, or in conjunction with, the social structure and built environment of women's neighborhood at birth.

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