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Maternal Birthplace, Ethnicity, and Low Birth Weight in California
Elena Fuentes-Afflick, MD, MPH;
Nancy A. Hessol, MSPH;
Eliseo J. Pérez-Stable, MD
Arch Pediatr Adolesc Med. 1998;152:1105-1112.
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.
From the Department of Pediatrics (Dr Fuentes-Afflick), Medical Effectiveness Research Center for Diverse Populations (Drs Fuentes-Afflick and Pérez-Stable), Department of Epidemiology and Biostatistics (Dr Fuentes-Afflick), Institute for Health Policy Studies (Dr Fuentes-Afflick), Department of Medicine (Ms Hessol and Dr Pérez-Stable), Department of Obstetrics, Gynecology and Reproductive Sciences (Ms Hessol), Division of General Internal Medicine (Dr Pérez-Stable), School of Medicine, University of California, San Francisco.
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