Maternal and Child Health Journal

, Volume 18, Issue 1, pp 90–100

Racial/Ethnic and Nativity Differences in Birth Outcomes Among Mothers in New York City: The Role of Social Ties and Social Support

  • Joanna Almeida
  • Candace Mulready-Ward
  • Vani R. Bettegowda
  • Indu B. Ahluwalia

DOI: 10.1007/s10995-013-1238-5

Cite this article as:
Almeida, J., Mulready-Ward, C., Bettegowda, V.R. et al. Matern Child Health J (2014) 18: 90. doi:10.1007/s10995-013-1238-5


Immigrants have lower rates of low birth weight (LBW) and to some extent preterm birth (PTB), than their US-born counterparts. This pattern has been termed the ‘immigrant health paradox’. Social ties and support are one proposed explanation for this phenomenon. We examined the contribution of social ties and social support to LBW and PTB by race/ethnicity and nativity among women in New York City (NYC). The NYC Pregnancy Risk Assessment Monitoring System survey (2004–2007) data, linked with the selected items from birth certificates, were used to examine LBW and PTB by race/ethnicity and nativity status and the role of social ties and social support to adverse birth outcomes using bivariate and multivariable analyses. SUDAAN software was used to adjust for complex survey design and sampling weights. US- and foreign-born Blacks had significantly increased odds of PTB [adjusted odds ratio (AOR) = 2.43, 95 % CI 1.56, 3.77 and AOR = 2.6, 95 % CI 1.66, 4.24, respectively] compared to US-born Whites. Odds of PTB among foreign-born Other Latinas, Island-born Puerto Ricans’ and foreign-born Asians’ were not significantly different from US-born Whites, while odds of PTB for foreign-born Whites were significantly lower (AOR = 0.47, 95 % CI 0.26, 0.84). US and foreign-born Blacks’ odds of LBW were 2.5 fold that of US-born Whites. Fewer social ties were associated with 32–39 % lower odds of PTB. Lower social support was associated with decreased odds of LBW (AOR 0.69, 95 % CI 0.50, 0.96). We found stronger evidence of the immigrant health paradox across racial/ethnic groups for PTB than for LBW. Results also point to the importance of accurately assessing social ties and social support during pregnancy and to considering the potential downside of social ties.


Low birth weight Preterm birth Race/ethnicity Immigrants Social ties Social support 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Joanna Almeida
    • 1
  • Candace Mulready-Ward
    • 2
  • Vani R. Bettegowda
    • 3
  • Indu B. Ahluwalia
    • 4
  1. 1.Simmons School of Social WorkBostonUSA
  2. 2.NYC Department of Health and Mental Hygiene, Bureau of MaternalInfant and Reproductive HealthNew YorkUSA
  3. 3.Perinatal Data CenterMarch of Dimes FoundationWhite PlainsUSA
  4. 4.Pregnancy Risk Assessment Monitoring System, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaUSA

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