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LETTER |
Correspondence: Requests for reprints should be sent to Catherine Stevens-Simon, MD, Department of Pediatrics, The Children's Hospital, 1056 E 19th Ave, Denver, CO 80218 (e-mail: stevens-simon.catherine{at}tchden.org).
I would like to offer a Darwinian alternative to the "weathering" hypothesis that Rauh and colleagues1 draw upon in explaining their findings regarding the interaction among maternal age, socioeconomic status, and race in the prediction of infant birthweight. I do not dispute the authors' assertion that "the impact of maternal age on birth outcomes may depend on some underlying processes associated with social or residential context,"1 but I suggest a need for caution in labeling these processes "weathering" and ascribing the poorer birth outcomes of the infants born to older African American women to the cumulative adverse effects of acquired ill health.
The data presented in Table 1 of Rauh et al. demonstrate that the distribution of births is very different among White and African American women. Among Whites, births are spread relatively evenly over the 15-year age span from 20 to 35 years; among African Americans, they are conspicuously concentrated within the 5-year age span from 20 to 25 years. This suggests that different selection pressures may be operating in the 2 populations. Specifically, my interpretation of these data is a that the White women in this sample may be doing more (i.e., abstaining from heterosexual vaginal intercourse or using contraceptives) to purposefully delay childbearing beyond their early 20s than the African American women.
Those African American and White women who do not conceive when the majority of their peers do (i.e., prior to age 25 years and 35 years, respectively) may or may not have delayed their pregnancies purposefully. To the extent that they did not, their innate subfecundity could put them at risk for the observed adverse pregnancy outcomes.2,3 Since Table 1 suggests that this natural selection process may not be operating to the same extent in the 2 racial groups, we need to know whether the childbearing delays were planned or unplanned before drawing any conclusions about the etiology of their apparent effect on infant birthweight.
Specifically, we need to know whether poor African American women who choose to delay childbearing are at a biological disadvantage. Finally, although I do not dispute the validity of the "weathering" hypothesis, I do dispute the often-made extension that this phenomenon makes early (and in particular teenaged) childbearing an adaptive strategy for the socially disadvantaged.4 Rather it seems to have become a popular strategy for adapting to social disadvantage, one that creates generation after generation of young Americans who learn how to live in poverty instead of how to fight it.
References
1.
Rauh VA, Andrews HF, Garfinkel RS. The contribution of maternal age to racial disparities in birthweight: a multilevel perspective. Am J Public Health.2001;91:1815–1824.
2. Funderburk S. Offspring of subfertile parents—a preliminary survey. Int J Fertil.1975;20:73–76.[Medline]
3. Stevens-Simon C, McAnarney ER. Infertility: a risk factor in adolescent and adult pregnancies. J Adolesc Health Care.1990;11:432–436.[Medline]
4. Geronimus AT. Teenage childbearing and social and reproductive disadvantage: the evolution of complex questions and the demise of simple answers. Fam Relations.1991;40:463–471.
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