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Maternal and Child Health Journal

, Volume 20, Issue 9, pp 1849–1860 | Cite as

Latina Birth Outcomes in California: Not so Paradoxical

  • Emma V. Sanchez-VaznaughEmail author
  • Paula A. Braveman
  • Susan Egerter
  • Kristen S. Marchi
  • Katherine Heck
  • Michael Curtis
Article

Abstract

Objectives To investigate Latina-White differences in birth outcomes in California from 2003 to 2010, looking for evidence of the often-cited “Latina paradox” and assessing the possible role of socioeconomic factors in observed differences. MethodsUsing statewide-representative data from the California Maternal and Infant Health Assessment, an annual population-based postpartum survey, we compared rates of preterm birth (PTB) and low birth weight (LBW) in five groups: U.S.-born non-Latina Whites (“Whites”), U.S.-born Mexican–Americans, U.S.-born non-Mexican Latinas, Mexican immigrants, and non-Mexican Latina immigrants. Logistic regression models examined the relative likelihood of PTB and LBW for women in each Latina subgroup compared with Whites, before and after adjustment for socioeconomic and other covariates. Results In unadjusted analyses, women in each Latina subgroup appeared more likely than White women to have PTB and LBW, although the increased likelihood of LBW among Mexican immigrants was statistically non-significant. After adjustment for less favorable socioeconomic characteristics among Latinas compared with Whites, observed differences in the estimated likelihoods of PTB or LBW for Latina subgroups relative to Whites were attenuated and (with the exception of PTB among U.S.-born Mexican Americans) no longer statistically significant. Conclusions We found no evidence of a “Latina paradox” in birth outcomes, which some have cited as evidence that social disadvantage is not always health-damaging. As observed in several previous studies, our findings were non-paradoxical: consistent with their socioeconomic disadvantage, Latinas had worse birth outcomes than non-Latina White women. Policy-makers should not rely on a “Latina paradox” to ensure good birth outcomes among socioeconomically disadvantaged Latina women.

Keywords

Latina paradox Disparities in preterm birth Low birth weight Socioeconomic factors 

Notes

Acknowledgments

The data used for this study were produced with funding from the California Department of Public Health, Maternal, Child and Adolescent Health Program. The study was supported in part by a grant from the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (Sanchez-Vaznaugh K01HL115471). The content in this article is solely the responsibility of the authors and does not necessarily represent the official views of the funding institutions.

References

  1. 1.
    Almeida, J., Mulready-Ward, C., Bettegowda, V. R., & Ahluwalia, I. B. (2014). Racial/ethnic and nativity differences in birth outcomes among mothers in New York City: The role of social ties and social support. Maternal and Child Health Journal, 18, 90–100.CrossRefPubMedGoogle Scholar
  2. 2.
    Brown, H. L., Chireau, M. V., Jallah, Y., & Howard, D. (2007). The “Hispanic paradox”: An investigation of racial disparity in pregnancy outcomes at a tertiary care medical center. American Journal of Obstetrics and Gynecology, 197(2), 197.e1–197.e9.CrossRefGoogle Scholar
  3. 3.
    Cervantes, A., Keith, L., & Wyshak, G. (1999). Adverse birth outcomes among native-born and immigrant women: Replicating national evidence regarding Mexicans at the local level. Maternal and Child Health Journal, 3(2), 99–109.CrossRefPubMedGoogle Scholar
  4. 4.
    Gagnon, A. J., Zimbeck, M., Zeitlin, J., Collaboration, R., Alexander, S., Blondel, B., et al. (2009). Migration to western industrialised countries and perinatal health: A systematic review. Social Science and Medicine, 69(6), 934–946.CrossRefPubMedGoogle Scholar
  5. 5.
    Gonzalez-Quintero, V. H., Tolaymat, L., Luke, B., Gonzalez-Garcia, A., Duthely, L., O’Sullivan, M. J., et al. (2006). Outcome of pregnancies among Hispanics: Revisiting the epidemiologic paradox. Journal of Reproductive Medicine, 51(1), 10–14.PubMedGoogle Scholar
  6. 6.
    Madan, A., Palaniappan, L., Urizar, G., Wang, Y., Fortmann, S. P., & Gould, J. B. (2006). Sociocultural factors that affect pregnancy outcomes in two dissimilar immigrant groups in the United States. Journal of Pediatrics, 148(3), 341–346.CrossRefPubMedGoogle Scholar
  7. 7.
    Sullivan, K., Raley, R. K., Hummer, R. A., & Schiefelbein, E. (2012). The potential contribution of marital-cohabitation status to racial, ethnic, and nativity differentials in birth outcomes in Texas. Maternal and Child Health Journal, 16(4), 775–784.CrossRefPubMedGoogle Scholar
  8. 8.
    Acevedo-Garcia, D., Soobader, M. J., & Berkman, L. F. (2005). The differential effect of foreign-born status on low birth weight by race/ethnicity and education. Pediatrics, 115(1), e20–e30.PubMedGoogle Scholar
  9. 9.
    Acevedo-Garcia, D., Soobader, M. J., & Berkman, L. F. (2007). Low birthweight among U.S. Hispanic/Latino subgroups: The effect of maternal foreign-born status and education. Social Science and Medicine, 65(12), 2503–2516.CrossRefPubMedGoogle Scholar
  10. 10.
    Guendelman, S., Buekens, P., Blondel, B., Kaminski, M., Notzon, F. C., & Masuy-Stroobant, G. (1999). Birth outcomes of immigrant women in the United States, France, and Belgium. Maternal and Child Health Journal, 3(4), 177–187.CrossRefPubMedGoogle Scholar
  11. 11.
    Hessol, N. A., & Fuentes-Afflick, E. (2000). The perinatal advantage of Mexican-origin Latina women. Annals of Epidemiology, 10(8), 516–523.CrossRefPubMedGoogle Scholar
  12. 12.
    Hessol, N. A., & Fuentes-Afflick, E. (2014). The impact of migration on pregnancy outcomes among Mexican-origin women. Journal of Immigrant and Minority Health, 16, 377–384.CrossRefPubMedGoogle Scholar
  13. 13.
    Sparks, P. J. (2009). Do biological, sociodemographic, and behavioral characteristics explain racial/ethnic disparities in preterm births? Social Science and Medicine, 68(9), 1667–1675.CrossRefPubMedGoogle Scholar
  14. 14.
    Fuentes-Afflick, E., Hessol, N. A., & Perez-Stable, E. J. (1998). Maternal birthplace, ethnicity, and low birth weight in California. Archives of Pediatrics and Adolescent Medicine, 152(11), 1105–1112.CrossRefPubMedGoogle Scholar
  15. 15.
    Fuentes-Afflick, E., Hessol, N. A., & Perez-Stable, E. J. (1999). Testing the epidemiologic paradox of low birth weight in Latinos. Archives of Pediatrics and Adolescent Medicine, 153(2), 147–153.CrossRefPubMedGoogle Scholar
  16. 16.
    Fuentes-Afflick, E., & Lurie, P. (1997). Low birth weight and Latino ethnicity. Examining the epidemiologic paradox. Archives of Pediatrics and Adolescent Medicine, 151(7), 665–674.CrossRefPubMedGoogle Scholar
  17. 17.
    Singh, G. K., & Yu, S. M. (1996). Adverse pregnancy outcomes: Differences between U.S.- and foreign-born women in major U.S. racial and ethnic groups. American Journal of Public Health, 86(6), 837–843.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Flores, M. E., Simonsen, S. E., Manuck, T. A., Dyer, J. M., & Turok, D. K. (2012). The “Latina epidemiologic paradox”: Contrasting patterns of adverse birth outcomes in U.S.-born and foreign-born Latinas. Womens Health Issues., 22(5), e501–e507.CrossRefPubMedGoogle Scholar
  19. 19.
    Franzini, L., Ribble, J. C., & Keddie, A. M. (2001). Understanding the Hispanic paradox. Ethnicity and Disease, 11(3), 496–518.PubMedGoogle Scholar
  20. 20.
    Williams, R. L., Binkin, N. J., & Clingman, E. J. (1986). Pregnancy outcomes among Spanish-surname women in California. American Journal of Public Health, 76(4), 387–391.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Berkowitz, G. S., Blackmore-Prince, C., Lapinski, R. H., & Savitz, D. A. (1998). Risk factors for preterm birth subtypes. Epidemiology, 9(3), 279–285.CrossRefPubMedGoogle Scholar
  22. 22.
    McGlade, M. S., Saha, S., & Dahlstrom, M. E. (2004). The Latina paradox: An opportunity for restructuring prenatal care delivery. American Journal of Public Health, 94(12), 2062–2065.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Callister, L. C., & Birkhead, A. (2002). Acculturation and perinatal outcomes in Mexican immigrant childbearing women: An integrative review. The Journal of Perinatal & Neonatal Nursing, 16(3), 22–38.CrossRefGoogle Scholar
  24. 24.
    Center for Disease Control and Prevention. (2002). State-specific trends in U.S., live births to women born outside the 50 States and the District of Columbia—United States, 1990 and 2000. Morbidity Mortality Weekly Report, 51, 1091–1095.Google Scholar
  25. 25.
    Markides, K. S., & Coreil, J. (1986). The health of Hispanics in the southwestern United States: An epidemiologic paradox. Public Health Reports, 101(3), 253–265.PubMedPubMedCentralGoogle Scholar
  26. 26.
    Hoggatt, K. J., Flores, M., Solorio, R., Wilhelm, M., & Ritz, B. (2012). The “Latina Epidemiologic Paradox” revisited: The role of birthplace and acculturation in predicting infant low birth weight for Latinas in Los Angeles, CA. Journal of Immigrant and Minority Health, 14(5), 875–884.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Dyer, J. M., Hunter, R., & Murphy, P. A. (2011). Relationship of social network size to infant birth weight in hispanic and non-hispanic women. Journal of Immigrant and Minority Health, 13(3), 487–493.CrossRefPubMedGoogle Scholar
  28. 28.
    Martin, J., Hamilton, B., Ventura, S., Osterman, J., Wilson, E., & Mathews, T. (2012). Births: Final data for 2010. National Vital Statistics Reports, 61, 1–72.Google Scholar
  29. 29.
    Blumenshine, P., Egerter, S., Barclay, C. J., Cubbin, C., & Braveman, P. A. (2010). Socioeconomic disparities in adverse birth outcomes: A systematic review. American Journal of Preventive Medicine, 39(3), 263–272.CrossRefPubMedGoogle Scholar
  30. 30.
    Braveman, P., Marchi, K., Egerter, S., Kim, S., Metzler, M., Stancil, T., et al. (2010). Poverty, near-poverty, and hardship around the time of pregnancy. Maternal and Child Health Journal, 14(1), 20–35.CrossRefPubMedGoogle Scholar
  31. 31.
    Rubin, D. (2007). Multiple imputation for nonresponse in surveys. New York: Wiley.Google Scholar
  32. 32.
    Cole, S., & Hernán, M. (2002). Fallibility in estimating direct effects. International Journal of Epidemiology, 31(1), 457–468.CrossRefGoogle Scholar
  33. 33.
    Glymour, M., & Greenland, S. (2008). Causal diagrams. In K. Rothman, S. Greenland, & T. Lash (Eds.), Modern epidemiology (3rd ed.). Philadelphia: Lippincott Williams & Wilkins.Google Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Emma V. Sanchez-Vaznaugh
    • 1
    • 2
    Email author
  • Paula A. Braveman
    • 2
  • Susan Egerter
    • 2
  • Kristen S. Marchi
    • 2
  • Katherine Heck
    • 2
  • Michael Curtis
    • 3
  1. 1.Department of Health EducationSan Francisco State UniversitySan FranciscoUSA
  2. 2.Center on Social Disparities in HealthUniversity of California San FranciscoSan FranciscoUSA
  3. 3.Surveillance, Assessment and Program Development Section, Epidemiology, Assessment and Program Development Branch, Maternal, Child and Adolescent Health ProgramCalifornia Department of Public HealthSacramentoUSA

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