not-yet-known not-yet-known not-yet-known unknown 5 Conclusion  A GRSBW derived from a European-ancestry cohort was not consistently associated with BW across self-identified race or genetically predicted ancestry groups, suggesting a lack of generalizability to populations of non-White race and non-European ancestry. These findings highlight the need for both globally representative genetic discovery cohorts and the use of analytical approaches that can incorporate the social and structural determinants that drive racial inequities in fetal growth. Such changes could maximize generalizability of genetic risk methods for disease prediction and improve equity in access and treatment. Prioritizing the generalizability of genetic findings is critical to prevent inadvertent exacerbation of longstanding health inequities by inequitable utility of advances in personalized medicine.