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: 4.25). 12/1998; 152(11):1105-12. DOI: 10.1001/archpedi.152.11.1105
Source: PubMed

ABSTRACT 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.

Download full-text


Available from: Eliseo J Pérez-Stable, Jun 22, 2015
  • Source
    [Show abstract] [Hide abstract]
    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 · 1.28 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Many public health and epidemiological studies have found differences between populations (e.g. maternal countries of birth) in average values of a health indicator (e.g. mean offspring birthweight). However, the approach based solely on population-level averages compromises our understanding of variability in individuals' health around the averages. If this variability is high, the exclusive study of averages may give misleading information. This idea is relevant when investigating country of birth differences in health. To exemplify this concept, we use information from the Swedish Medical Birth Register (2002-2010) and apply multilevel regression analysis of birthweight, with babies (n = 811,329) at the first, mothers (n = 571,876) at the second, and maternal countries of birth (n = 109) at the third level. We disentangle offspring, maternal and maternal country of birth components of the total offspring heterogeneity in birthweight for babies born within the normal timespan (37-42 weeks). We found that of such birthweight variation about 50% was at the baby level, 47% at the maternal level and only 3% at the maternal countries of birth level. In spite of seemingly large differences in average birthweight among maternal countries of birth (range 3290-3677g), knowledge of the maternal country of birth does not provide accurate information for ascertaining individual offspring birthweight because of the high inter-offspring heterogeneity around country averages. Our study exemplifies the need for a better understanding of individual health diversity for which group averages may provide insufficient and even misleading information. The analytical approach we outline is therefore relevant to investigations of country of birth (and ethnic) differences in health in general.
    PLoS ONE 05/2015; 10(5):e0129362. DOI:10.1371/journal.pone.0129362 · 3.53 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To compare the association between neighborhood Latino immigrant concentration and infant mortality by maternal nativity among singleton births to Mexican-origin women in Los Angeles County. Information about births, infant deaths, and infant and maternal characteristics were obtained from geocoded Los Angeles County vital statistics records (2002-2005). Linked data on neighborhood characteristics (census tracts) were obtained from the 2000 census. Logistic regression models were used to predict infant mortality while accounting for spatial clustering by census tract. Two-thirds of births to Mexican-origin mothers were to foreign-born women. Foreign-born mothers were older, had less education, and were more likely to have delivery costs paid by Medicaid than US-born mothers. Infants born to foreign-born women had a lower infant mortality rates than infants born to US-born women (3.8/1,000 live births vs. 4.6, p = .002). Among infants of foreign-born mothers, the odds of infant mortality increased with increasing immigrant concentration (OR 1.29; 95 % CI 1.01-1.66). There was a similar pattern of association between immigrant concentration and mortality for infants of US-born mothers (OR 1.29; 95 % CI 0.99-1.67). In Los Angeles County, the odds of infant mortality among foreign-born Mexican-origin Latina were higher in higher-density immigrant neighborhoods, with a similar trend among US-born mothers. Thus, living in immigrant enclaves likely does not help to explain the lower than expected infant mortality rate among infants born to Latina women. Instead, higher neighborhood Latino immigrant concentration may indicate a neighborhood with characteristics that negatively impact maternal and infant health for Latinos.
    Maternal and Child Health Journal 11/2014; 19(6). DOI:10.1007/s10995-014-1640-7 · 2.24 Impact Factor