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Birth weight is a strong predictor of the health of newborns. Consequently, the report by Catov et al. in this issue of the Journal (Am J Epidemiol. 2016;183(1):15-23), in which they showed downward trends in birth weights in a Pittsburgh, Pennsylvania, hospital from 1997 to 2011, raises concerns. The widening gap reported between birth weights of babies born to white and African-American women could correspond to a widening gap in actual health outcomes. However, if the relation between birth weight and health outcomes is not causal, these trends may be epiphenomena of limited concern.