Baseline Differences and Comparative Change in Pregnancy and Birth Outcomes for the Asian Indian American Population:...

To analyze changes in pregnancy and birth outcomes for the rapidly growing Asian Indian American (AIA) population between 2014 and 2024, comparing foreign born to US born individuals.

Using national singleton birth certificate data, logistic and Poisson regression models tested the significance of year and nativity status for ten adverse pregnancy and birth outcomes, adjusting for pre-pregnancy sociodemographic and clinical characteristics.

There were 57,684 births in 2014 (90.0% immigrant) and 71,398 births in 2024 (86.9% immigrant), reflecting a 23.8% increase. In 2024 the AIA population was older and more educated with a higher prevalence of pre-pregnancy hypertension, diabetes, and obesity. In adjusted analyses, there was an 85% increase in the likelihood of any hypertensive disorder of pregnancy, a 35% increase in the likelihood of gestational diabetes, and a 72% increase in the likelihood of not initiating breastfeeding.

The AIA birthing population is affected by increasing pre-pregnancy risk factors and adverse metabolic and hypertensive conditions. By 2024, over 20% of AIA birthing individuals experienced at least one adverse pregnancy or birth outcome. These findings pose a major life course challenge to the health of pregnant individuals and their offspring that require both public health and clinical interventions.