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The higher incidence of a very low birth weight among black infants compared to white infants may be caused by poorer maternal health. Pregnant women with poor health may have a higher risk of premature delivery than other women. A study reviewed the medical records of 1,299 infants with a birth weight between 500 and 1,499 grams and those of their mothers. The risk of a very low birth weight was approximately two to three times higher among black infants than among white infants. The risk of several major conditions associated with a very low birth weight was much higher among the mothers of black infants than among mothers of the white infants. These conditions included premature rupture of the amniotic sac, premature labor of unknown cause, high blood pressure and hemorrhaging. Black women need to have better medical care during their pregnancy and at the time of delivery.

The infant mortality rate in the US has declined since the 1960s, but large differences in infant mortality still exist between different racial groups. A research study found that among infants born to college-educated parents, the mortality rate was higher among black infants than among white infants. Higher mortality among black infants was caused by higher rates of low and very low birth weight. Social variables used by health researchers to assess racial differences in infant mortality may not fully reflect differences between racial groups in the US. Although parent income and education may be the same, middle-class white families may still have more economic resources than black families. Social differences between races are complex, and are difficult to characterize. An interdisciplinary approach and more communication between medical researchers and health care workers is needed to more fully understand differences in infant mortality between different racial groups.