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Maternal Health
Stressful events have been demonstrated to produce significant effects on birth weight. Those mothers who have stressful events during pregnancy, especially during the first and second trimester, are at higher risk to deliver low-birth weight babies. Researchers furthered this study and found that maternal stressful events that occur prior to conception have a negative impact on birth weight as well, and can result in a higher risk for preterm and lower birth weight babies. . Women who experienced abuse (physical, sexual, or emotional) during pregnancy are also at increased risk of delivering a low-birth weight baby. For example, in a study completed by Witt et. al, those women who experienced a stressful event (ie. dealth of close family member, infertility issues, separation from partner) prior to conception had 38 % more of a chance to have a very low birth weight baby compared to those who had not experienced a stressful life event. These findings can pose evidence for future prevention efforts for low birthweight babies. One way to decrease rates of low birth weight and premature delivery is to focus on the health of women prior to conception through reproductive education, screening and counseling regarding mental health issues and stress, and access to primary care.

The association between stress and low-birth weight originates from the a few hypotheses. The first is that when the body is under stress, certain chemicals, like coritsol are released in high levels which can be detrimental to the growing fetus. ** more about maternal stress and how it affects nueroendocrine ,immune, inflammatory**. Also women who are experiencing high levels of stress may turn to unhealthy coping behaviors that have been demonstrated with an increased risk of low- birth weight ( i.e drinking alcohol, cigarette smoking etc.)

Still to add

 * Genetics
 * Secondhand smoke
 * Country Stats
 * Effects after birth

Racial Stress
Non-Hispanic Blacks have the highest infant mortality rate in the United States (11.4%, compared to the national average of 5.9%). Subsequently, there has been growing research supporting the idea of racial discrimination as a risk factor for low birth weight. In one study by Collins et. al, evidence suggested that African American mothers who experienced high levels of racial discrimination were at significantly higher risk of delivering a very low-birth weight baby compared to African American mothers who had not experienced racial discrimination. Black infants (13.2 %) are more likely to have low birth weight compared to Asian and Pacific Islander (8.1%), American Indian and Alaska Native (7.6%), Non-Hispanic White (7.0%), and Hispanic Infants (7.1%).

Around the World
There is much variation regarding birth weight within continents, countries, and cities. Even though over 20 million babies are born each year with low birth weight, it is hard to know the exact number as more than half of babies born in the world are not weighed at birth.

What Can Be Done?
The World Health Organization (WHO) recently announced an initiative to have a 30 % reduction in low birth weight worldwide. This is public health priority, as birth weight can have short and long term effects. WHO estimates that worldwide, 15-20 % of all births each year are considered low birth weight, which is about 20 million births.

One essential action to increase normal birth weights is to have affordable ,accessible, and culturally sensitive prenatal care worldwide. This is essential not just for treating low birth weight, but also preventing it. Other prevention efforts include: smoking cessation programs, food-distribution systems, stress reduction and social service supports.