Maternal Birthplace, Ethnicity, and Low Birth Weight in California

Department of Pediatrics, Medical Effectiveness Research Center for Diverse Populations, Institute for Health Policy Studies, University of California, San Francisco 94110, USA.
Archives of Pediatrics and Adolescent Medicine (Impact Factor: 5.73). 12/1998; 152(11):1105-12. DOI: 10.1001/archpedi.152.11.1105
Source: PubMed


Although immigrants to the United States are usually ethnic minorities and socioeconomically disadvantaged, foreign-born women generally have lower rates of low birth weight infants than do US-born women.
To measure the relationship between maternal birthplace, ethnicity, and low birth weight infants.
Retrospective cohort study of birth certificate data.
California, 1992.
Singleton infants (n = 497 868) born to Asian, black, Latina, and white women.
Very low birth weight (500-1499 g), moderately low birth weight (1500-2499 g), and normal birth weight (2500-4000 g, reference category).
Foreign-born Latina women generally had less favorable maternal characteristics than US-born Latinas, yet foreign-born Latina women were less likely to have moderately low birth weight infants (odds ratio, 0.91; 95% confidence interval, 0.86-0.96) than US-born Latinas after adjusting for maternal age, education, marital status, parity, tobacco use, use of prenatal care, and gestational age. While foreign-born Asian women generally had a less favorable profile of maternal characteristics than US-born Asians, there was no statistically significant difference in the odds of very low birth weight or moderately low birth weight infants between foreign- and US-born Asian women. Foreign-born black women had more favorable maternal characteristics than US-born women, but there was no significant nativity difference in very low birth weight or moderately low birth weight between foreign- and US-born black women after adjusting for maternal and infant factors.
The relationship between maternal birthplace and low birth weight varies by ethnicity. Further study is needed to understand the favorable pregnancy outcomes of foreign-born Latina women.

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Available from: Eliseo J Pérez-Stable,
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    • "This phenomenon is referred to as the “Hispanic Epidemiologic Paradox” [5–7]. One hypothesis to explain this paradox is “selective migration,” which suggests that immigrant women are a healthier subset of the population of origin and therefore have better than expected birth and other health outcomes because they have been positively selected by the migration process due to physical, mental or other health characteristics [1, 3–5, 8, 9]. Another hypothesis is that cultural traditions and behaviors followed in Mexico protect women for some period of time after they immigrate from risks associated with disadvantaged socioeconomic status once in the US [10–12]. "
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    ABSTRACT: In the US, Mexican immigrant women often have better health outcomes than non-Hispanic white women despite a greater health risk profile. This cross-sectional pilot study compared women living in Chavinda, Michoacán (n = 102) to women who had migrated from Mexico to Madera, California (n = 93). The interview gathered information on acculturation and risk behaviors including smoking, alcohol use and number of sexual partners. The results suggest that more acculturated women living in the US are more likely to consume alcohol. US residence and higher acculturation level was marginally associated with having more than one sexual partner. There were no differences between odds of smoking among Chavinda and Madera women. While results with acculturation are not consistently significant due to small sample sizes, the results are suggestive that acculturation among immigrant Hispanic women in the US may be associated with adverse health behaviors, and selective migration seems less likely to account for these differences.
    Journal of Immigrant and Minority Health 12/2011; 13(6):1142-9. DOI:10.1007/s10903-010-9387-8 · 1.16 Impact Factor
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    • "influence adult perinatal outcomes (Acevedo-Garcia et al. 2005, Chen et al. 2007); second, as suggested in previous research (Nicolaidis et al. 2004), educational attainment proves a less reasonable marker for maternal SES for teenage mothers since they may not have completed their schooling. LBW was defined as between 500 and 2499 g and normal birth weight between 2500 and 4000 g; birth weights below 500 g (n 031) and above 4000 g (n 06496) were excluded from the analysis (Armstrong et al. 1998, Fuentes-Afflick et al. 1998). High birth weights correlate differently with cardiovascular risk factors, for example, obesity, in later childhood and adolescence (Wen et al. 2007). "
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    ABSTRACT: Studies in the USA suggest that the association between maternal birthplace, socioeconomic status (SES), and low birth weight (LBW) can vary across different immigrant groups. Less is known outside the USA about these associations. Our study assesses the association of maternal birthplace and SES on the likelihood of LBW infants in Québec, Canada. Using 2000 Quebec birth registry data, logistic regression was used to examine differentials in LBW according to maternal birthplace and SES. Singleton infants born to Québec mothers (n=47,988) were grouped into nine regions based on maternal birthplace: (1) Canada; (2) the USA and western Europe; (3) eastern Europe; (4) Latin America; (5) the Caribbean; (6) Sub-Saharan Africa; (7) north Africa and Middle East; (8) South Asia; and (9) East Asia and Pacific. SES was classified into four categories according to maternal educational attainment: (1) low SES (<11 years); (2) medium-low SES (11-12 years); (3) medium-high SES (13-14 years); and (4) high SES (more than 14 years). Covariates included maternal age, gestational duration, and parity. LBW was defined as between 500 and 2499 g. Compared to a LBW prevalence of 4.5 for Canadian-born mothers, South Asian- and Caribbean-born mothers had prevalence percentages of 9.2 and 8.2, respectively. After adjusting for SES and other covariates, the likelihood (odds ratio (OR), 95% confidence intervals (CI)) of LBW outcomes remained greater for South Asian- (OR 2.84; 95% CI, 1.90-4.24) and Caribbean-born mothers (OR 1.52; 95% CI 1.11-2.10). After pooling these two groups and testing for moderation by SES, we found that high SES immigrant mothers (OR 3.82; 95% CI 2.33-6.25) had a higher likelihood of LBW infants than low SES mothers (OR 2.00; 95% CI 1.22-3.33) compared to high SES Canadian-born mothers. In Québec, the association between foreign-born status and LBW varies according to maternal birthplace.
    Ethnicity and Health 02/2009; 14(1):61-74. DOI:10.1080/13557850802071132 · 1.67 Impact Factor
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    • "Studies of Latin women of Mexican decent have demonstrated that immigrant groups tend to have healthier birth outcomes than would be expected from their socioeconomic profile, and that they are less likely to experience an adverse outcome with their first pregnancy than they are with subsequent pregnancies [9-11]. Studies of maternal characteristics and birth outcomes in migrant workers have shown that these women delay seeking prenatal care and gain significantly less weight during pregnancy than their non-migrant counterparts [6]. "
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    ABSTRACT: The birth outcomes of undocumented women have not been systematically studied on a large scale. The growing number of undocumented women giving birth in the United States has important implications for clinical care and public health policy. The objective of this study was to describe birth outcomes of undocumented immigrants in Colorado. Retrospective descriptive study of singleton births to 5961 undocumented women using birth certificate data for 1998-1999. Undocumented mothers were younger, less educated, and more likely to be single. They had higher rates of anemia, were less likely to gain enough weight, and less likely to receive early prenatal care. They were much less likely to use alcohol or tobacco. Undocumented women had a lower rate of low birth weight (5.3% v 6.5%, P < .001) or preterm infants (12.9% v 14.5%; p = .001). Undocumented women experienced higher rates of labor complications including excessive bleeding (2.3% v 0.8%, p < .001) and fetal distress (8.7% v 3.6%, p < .001). Undocumented women have lower rates of preterm delivery and low birth weight infants, but higher rates of pregnancy related risk factors. Higher prevalence of some risk factors which are amenable to medical intervention reveals the need for improved prenatal care in this group.
    BMC Public Health 10/2005; 5(1):100. DOI:10.1186/1471-2458-5-100 · 2.26 Impact Factor
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