Babies’ birthweight and other birth outcomes affect their health, development and learning during the early years, which impacts third grade reading outcomes.
Babies born weighing less than 5.5 pounds are at greater risk for physical, developmental and learning problems than infants of normal weight, including:
- Short- and long-term illness or disability
- Learning disorders
- Behavioral problems
- Enrollment in special education classes
- Grade retention
- School failure1
Low birthweight babies generally score lower on reading, passage comprehension, and math achievement tests.2
Low birthweight impacts Black babies at a higher rate than white babies, regardless of mother’s income. Effective strategies to improve healthy birthweight rates focus on pre-pregnancy health, with a particular focus on supporting women of color.

State Center for Health Statistics, North Carolina
)State Center for Health Statistics, North Carolina
)State Center for Health Statistics, North Carolina
)What Can We Do About It?
What supports healthy birthweight?
- Policies and practices that focus on improving women’s general pre-pregnancy health (including addressing unhealthy behaviors) and prenatal and inter-conception care, with particular attention to groups at high risk for low birthweight births.
- Two-generation approaches and evidence-based programs that support mothers’ health, provide parenting education and support, and support children’s health and learning.
North Carolina’s Perinatal Health Strategic Plan: North Carolina adapted national research to develop a 12-point framework designed to improve health care prenatally and between pregnancies, enhance the coordination of services, and address inequities. The plan is in the implementation phase.1
Improving Community Outcomes for Maternal and Child Health: This initiative within the North Carolina Department of Health and Human Services will fund evidence-based strategies to improve birth outcomes and reduce infant mortality. It will focus on
- Use of long-acting reversible contraceptives
- Smoking cessation and prevention
- Triple P interventions.2 Triple P is a parenting education program that aims to increase the knowledge, skills and confidence of parents and reduce mental health, emotional and behavioral problems in children.
Featured Resources
What Works for Third Grade Reading: Healthy Birthweight
considers why a healthy birthweight matters for third grade reading proficiency, outlines its connections with other factors that impact early literacy, and highlights options that have been shown to move the needle on low birthweight and premature births. It is one of 12 new working papers that offer research-based policy, practice and program options to states and communities working to improve third grade reading proficiency.
Research Basis for Pathways Measures of Success Framework
This resource provides data definitions of the Measures of Success and shares the research for each measure, demonstrating the connections between the measures and third-grade reading proficiency. A list of sources is included for each group of measures.
Investing in North Carolina's Healthy Future
A fact sheet to highlights the interconnectedness of health and learning.
What Works for Third Grade Reading: An Overview of the NC Pathways to Grade-Level Reading
The paper provides an introduction to a series of 12 working papers that offer research-based policy, practice and program options to states and communities working to improve third grade reading proficiency. Read this document first before delving into the papers.