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Maternal birthplace, ethnicity, and low birth weight in California
E Fuentes-Afflick1, N A Hessol, E J Pérez-Stable
1Department of Pediatrics, Medical Effectiveness Research Center for Diverse Populations, Institute for Health Policy Studies, University of California, San Francisco 94110, USA. elenaf@itsa.ucsf.edu
Background:
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.
Objective:
To measure the relationship between maternal birthplace, ethnicity, and low birth weight infants.
Design:
Retrospective cohort study of birth certificate data.
Setting:
California, 1992.
Subjects:
Singleton infants (n = 497 868) born to Asian, black, Latina, and white women.
Main Outcome Measures:
Very low birth weight (500-1499 g), moderately low birth weight (1500-2499 g), and normal birth weight (2500-4000 g, reference category).
Results:
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.
Conclusions:
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.