Low birthweight among US Hispanic/Latino subgroups: the effect of maternal foreign-born status and education

Dolores Acevedo-Garcia, Mah-J Soobader, Lisa F Berkman
Social Science & Medicine 2007, 65 (12): 2503-16
We investigated whether maternal foreign-born status confers a protective effect against low birthweight (LBW) across US Hispanic/Latino subgroups (i.e., Mexicans, Puerto Ricans, Cubans and Central/South Americans) in the USA, and whether the association between maternal education and LBW varies by Hispanic/Latino subgroup and by foreign-born status. We conducted logistic regression analyses of the 2002 US Natality Detail Data (n=634,797). Overall, foreign-born Latino women are less likely to have LBW infants than US-born Latino women. The protective effect of foreign-born status is stronger among Latino women with less than high school education. The maternal education gradient is significantly flatter among foreign-born Latino women than among their US-born counterparts (p<0.001). Patterns among Mexican-origin women account for the overall trends among all Latinos.Foreign-born status (main effect) reduces the risk of LBW among Mexicans by about 21% but does not protect against LBW among other Latino subgroups (i.e., Puerto Ricans, Cubans and Central/South Americans). Among Mexicans and Central South Americans, the protective effect of foreign-born status is stronger among women with low education (i.e., 0-11 and 12 years) than among women with more education (i.e., 13-15 and 16+ years). The educational gradient in LBW is less pronounced among foreign-born Mexicans and Central/South Americans than among their US-born counterparts. As such, maternal foreign-born status and education are associated with LBW, though the direction and strength of these associations vary across Latino subgroups. A "health paradox" is apparent for foreign-born Mexican and Central/South American women among whom there is a weak maternal educational gradient in LBW. Future research may test hypotheses regarding the mechanisms underlying these variations in LBW among Latino subgroups, i.e., different gradients in sending countries, health selection of immigrants, cultural factors, and social support.

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