Pregnancy Outcomes among Hispanics Stratified by Country of Origin

Abstract

Objective This study aimed to compare the perinatal outcomes among U.S.-born and foreign-born Hispanics and Caucasians and ascertain if length of time in the US was associated with the rate of adverse outcomes.

Study Design Retrospective cohort analysis of gravidae enrolled in our institutional perinatal database. Women delivering a non-anomalous, singleton, at 24 weeks or more and self-identified as Caucasian or Hispanic were included. Women were stratified by country of birth and ethnicity into U.S.-born Caucasian, U.S.-born Hispanic, and U.S. foreign-born Hispanic. Composite maternal (CMM) and neonatal (CNM) morbidity was assessed.

Results Of 20,422 women, 21% were Caucasian, 15% were U.S.-born Hispanics, and 64% were U.S. foreign-born Hispanics. Compared to Caucasians, U.S.-born and foreign-born Hispanic were older, more likely to be a grand multiparous, obese and less likely to be married. Compared to Caucasians, foreign-born Hispanics had a 1.42-fold increased risk of CMM (95% CI 1.26–1.30). Paradoxically, the rate of CNM was 40% lower among neonates born to foreign-born Hispanics (95% CI 0.51–0.74). A significant direct relationship was noted between time in the USA and CMM but not CNM among foreign-born Hispanics.

Conclusion Despite less favorable baseline characteristics, U.S. foreign-born Hispanics have 40% less CNM compared to both Caucasians and U.S.-born Hispanics.

Keywords

Hispanic - perinatal outcomes - paradox - pregnancy

Condensation

In spite of baseline at-risk characteristics, foreign-born Hispanics have lower composite neonatal morbidity than U.S.-born Hispanics and Caucasians.

Publikationsverlauf

Eingereicht: 15. Mai 2019

Angenommen: 07. September 2019

Artikel online veröffentlicht:
26. Oktober 2019

• References

• 1 Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Drake P. Births: Final data for 2016. Natl Vital Stat Rep 2016; 67: 1-55
• 2 Markides KS, Coreil J. The health of Hispanics in the southwestern United States: an epidemiologic paradox. Public Health Rep 1986; 101 (03) 253-265
• 3 Brown HL, Chireau MV, Jallah Y, Howard D. The “Hispanic paradox”: an investigation of racial disparity in pregnancy outcomes at a tertiary care medical center. Am J Obstet Gynecol 2007; 197 (02) 197.e1-197.e7
• 4 Chen HY, Chauhan SP, Rankins NC, Ananth CV, Siddiqui DS, Vintzileos AM. Racial and ethnic disparities in infant mortality in the United States: the role of gestational age. Am J Perinatol 2013; 30 (06) 469-475
• 5 Bryant AS, Worjoloh A, Caughey AB, Washington AE. Racial/ethnic disparities in obstetric outcomes and care: prevalence and determinants. Am J Obstet Gynecol 2010; 202 (04) 335-343
• 6 Kung HC, Hoyert DL, Xu J, Murphy SL. Deaths: final data for 2005. Natl Vital Stat Rep 2008; 56 (10) 1-120
• 7 Thomson EF, Nuru-Jeter A, Richardson D, Raza F, Minkler M. The Hispanic paradox and older adults' disabilities: is there a healthy migrant effect?. Int J Environ Res Public Health 2013; 10 (05) 1786-1814
• 8 Fuentes-Afflick E, Hessol NA, Pérez-Stable EJ. Maternal birthplace, ethnicity, and low birth weight in California. Arch Pediatr Adolesc Med 1998; 152 (11) 1105-1112
• 9 Martin JA, Hamilton BE, Sutton PD. et al. Births: final data for 2007. Natl Vital Stat Rep 2010; 58 (24) 1-85
• 10 Frisbie WP, Biegler M, de Turk P, Forbes D, Pullum SG. Racial and ethnic differences in determinants of intrauterine growth retardation and other compromised birth outcomes. Am J Public Health 1997; 87 (12) 1977-1983
• 11 Koshar JH, Lee KA, Goss G, Heilemann MS, Stinson J. The Hispanic teen mother's origin of birth, use of prenatal care, and maternal and neonatal complications. J Pediatr Nurs 1998; 13 (03) 151-157
• 12 Weinman ML, Smith PB. U.S.- and Mexico-born Hispanic teen mothers: a descriptive study of factors that relate to postpartum compliance. Hisp J Behav Sci 1994; 16 (02) 186-194
• 13 Albrecht SL, Miller MK. Hispanic subgroup differences in prenatal care. Soc Biol 1996; 43 (1-2): 38-58
• 14 Collins Jr JW, Martin CR. Relation of traditional risk factors to intrauterine growth retardation among United States-born and foreign-born Mexican Americans in Chicago. Ethn Dis 1998; 8 (01) 21-25
• 15 Arias E, Eschbach K, Schauman WS, Backlund EL, Sorlie PD. The Hispanic mortality advantage and ethnic misclassification on US death certificates. Am J Public Health 2010; 100 (Suppl. 01) S171-S177
• 16 Houston Region Grows More Racially/Ethnically Diverse, with Small Declines in Segregation. Accessed January 30, 2018 at: https://kinder.rice.edu/uploadedFiles/Urban_Research_Center/Media/Houston%20Region%20Grows%20More%20Ethnically%20Diverse%202-13.pdf
• 17 Antony KM, Hemarajata P, Chen J. et al. Generation and validation of a universal perinatal database and biospecimen repository: PeriBank. J Perinatol 2016; 36 (11) 921-929
• 18 Weaver CN, Martinez ZL. Should Hispanic persons from different countries of origin be combined into one sample for analysis?. Psychol Rep 2000; 86 (02) 355-364
• 19 Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M. A United States national reference for fetal growth. Obstet Gynecol 1996; 87 (02) 163-168
• 20 von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg 2014; 12 (12) 1495-1499
• 21 Cobas JA, Balcazar H, Benin MB, Keith VM, Chong Y. Acculturation and low-birthweight infants among Latino women: a reanalysis of HHANES data with structural equation models. Am J Public Health 1996; 86 (03) 394-396
• 22 Guendelman S, Thornton D, Gould J, Hosang N. Obstetric complications during labor and delivery: assessing ethnic differences in California. Womens Health Issues 2006; 16 (04) 189-197
• 23 Anadkat JS, Kuzniewicz MW, Chaudhari BP, Cole FS, Hamvas A. Increased risk for respiratory distress among white, male, late preterm and term infants. J Perinatol 2012; 32 (10) 780-785
• 24 Davis EM, Zyzanski SJ, Olson CM, Stange KC, Horwitz RI. Racial, ethnic, and socioeconomic differences in the incidence of obesity related to childbirth. Am J Public Health 2009; 99 (02) 294-299
• 25 Lawrence JM, Contreras R, Chen W, Sacks DA. Trends in the prevalence of preexisting diabetes and gestational diabetes mellitus among a racially/ethnically diverse population of pregnant women, 1999-2005. Diabetes Care 2008; 31 (05) 899-904
• 26 From the Center of Disease Control and Prevention. State-specific trends in US live births to women born outside the 50 states and the District of Columbia--United States, 1990 and 2000. JAMA 2003; 289 (12) 1503-1505
• 27 Singh GK, Yu SM. Adverse pregnancy outcomes: differences between US- and foreign-born women in major US racial and ethnic groups. Am J Public Health 1996; 86 (06) 837-843
• 28 Forna F, Jamieson DJ, Sanders D, Lindsay MK. Pregnancy outcomes in foreign-born and US-born women. Int J Gynaecol Obstet 2003; 83 (03) 257-265
• 29 Scribner R, Dwyer JH. Acculturation and low birthweight among Latinos in the Hispanic HANES. Am J Public Health 1989; 79 (09) 1263-1267
• 30 Zambrana RE, Scrimshaw SC, Collins N, Dunkel-Schetter C. Prenatal health behaviors and psychosocial risk factors in pregnant women of Mexican origin: the role of acculturation. Am J Public Health 1997; 87 (06) 1022-1026
• 31 Ruiz RJ, Saade GR, Brown CE. et al. The effect of acculturation on progesterone/estriol ratios and preterm birth in Hispanics. Obstet Gynecol 2008; 111 (2 Pt 1): 309-316