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Soc Sci Med. 2018 Jun;207:89-96. doi: 10.1016/j.socscimed.2018.04.049. Epub 2018 Apr 30.

Intergenerational pathways linking maternal early life adversity to offspring birthweight.

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Department of Sociology, University of California, Irvine, 4171 Social Sciences Plaza, Irvine, CA 92697, USA. Electronic address:
Carolina Population Center, University of North Carolina, 206 West Franklin Street, Chapel Hill, NC 27516, USA; Department of Sociology, University of North Carolina, Hamilton Hall, Chapel Hill, NC 27599-3210, USA.
Carolina Population Center, University of North Carolina, 206 West Franklin Street, Chapel Hill, NC 27516, USA; Department of Public Health Sciences, University of Virginia, 560 Ray C. Hunt Drive, Charlottesville, VA 22903, USA.


Adverse birth outcomes can lead to problematic long-term outcomes for children, and are also known to transmit socioeconomic disadvantage across generations, thereby amplifying the importance of identifying their social determinants. However, the full set of factors causing adverse birth outcomes remains unknown. Drawing together theory describing intragenerational (life course) processes linking early life adversity to adult health, and intergenerational transmissions of inequality via birthweight, this study tests a chain of risk that originates within early adolescence, impacts young women's risky health behaviors in late adolescence/early adulthood and risky health behaviors during pregnancy, and ultimately decreases offspring's birthweight. We do so using structural equation models and prospective, population-level data on a racially and socioeconomically diverse cohort of young adults (National Longitudinal Study of Adolescent to Adult Health). Results (a) reveal four pathways that fully mediate the association between a young woman's family-of-origin socioeconomic status in adolescence and her offspring's birthweight, and (b) identify a trigger effect-a place in the chain of risk where prevention efforts could be targeted, thereby breaking the chain of risk leading to poor offspring health at birth for vulnerable individuals.


Adolescent smoking; Birthweight; Intergenerational; Life course; Population health; Preconception; Prenatal smoking; U.S

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