Skip to main content

Ethnic/Racial Disparities in the Fetal Growth Outcomes of Ecuadorian Newborns

An Erratum to this article was published on 02 August 2016

Abstract

Size at birth is an important indicator of future infant morbidity and mortality. Ethnic/racial disparities in birth weight and other fetal growth outcomes are well documented for US and Canadian minority groups but not for those in Latin America. The study compared the growth outcomes of 1,227 full-term Ecuadorian newborns delivered by Afro-descendant and indigenous minority women with those of ethnic majority (mestizo) women. Minority newborns had higher risk for congenital microcephaly but no excess risk for low birth weight or stunted linear growth compared to mestizos. However, minority newborns were significantly heavier at birth, weighing an average of 3–5% more than mestizos. Afro-Ecuadorians newborns also were fatter. The risk profile of Ecuadorian ethnic groups for certain fetal growth outcomes differs from some of those reported for North American minorities. Further studies are needed to investigate the origins of these between-group differences and to develop ethnic specific interventions for adverse growth outcomes.

This is a preview of subscription content, access via your institution.

References

  1. McIntire DD, Bloom SL, Casey BM, Leveno KJ. Birth weight in relation to morbidity and mortality among newborn infants. N Engl J Med. 1999;340(16):1234–8.

    PubMed  Article  CAS  Google Scholar 

  2. Mehta SH, Kruger M, Sokol RJ. Being too large for gestational age precedes childhood obesity in African Americans. Am J Obstet Gynecol. 2011;204:265.e1–5.

    Article  Google Scholar 

  3. Hui LL, Schooling CM, Leung SSL, et al. Birth weight, infant growth and childhood body mass index: Hong Kong’s Children of 1997 birth cohort. Arch Pediatr Adolesc Med. 2008;162:212–8.

    PubMed  Article  CAS  Google Scholar 

  4. Baird J, Fisher D, Lucas P, Kleijnen J, Roberts H, Law C. Being big or growing fast: systematic review of size and growth in infancy and later obesity. BMJ. 2005;331:929.

    PubMed  Article  Google Scholar 

  5. Yu ZB, Han SP, Zhu GZ, Zhu C, Wang XJ, Cao XG, Guo XR. Birth weight and subsequent risk of obesity: a systematic review and meta-analysis. Obes Rev. 2011;. doi:10.1111/j.1467-789X.2011.00867.x.

    PubMed  Google Scholar 

  6. Birgisdottir BE, Gunnarsdottir I, Thorsdottir I, Gudnason V, Benediktsson R. Size at birth and glucose intolerance in a relatively genetically homogeneous, high-birth weight population. Am J Clin Nutr. 2002;76(2):399–403.

    PubMed  CAS  Google Scholar 

  7. Dudenhausen JW, Plagemann A. Birth weight, early weight gain, and subsequent risk of type 1 diabetes: systematic review and meta-analysis. Am J Epidemiol. 2009;169:1428–36.

    PubMed  Article  Google Scholar 

  8. Whincup PH, Kaye SJ, Owen CG, Huxley R, Cook DG, Anazawa S, Barrett-Connor E, Bhargava SK, Birgisdottir BE, Carlsson S, de Rooij SR, Dyck RF, Eriksson JG, Falkner B, Fall C, Forsén T, Grill V, Gudnason V, Hulman S, Hyppönen E, Jeffreys M, Lawlor DA, Leon DA, Minami J, Mishra G, Osmond C, Power C, Rich-Edwards JW, Roseboom TJ, Sachdev HS, Syddall H, Thorsdottir I, Vanhala M, Wadsworth M, Yarbrough DE. Birth weight and risk of type 2 diabetes: a systematic review. JAMA. 2008;300(24):2886–97.

    PubMed  Article  CAS  Google Scholar 

  9. Gamborg M, Byberg L, Rasmussen F, Andersen PK, Baker JL, Bengtsson C, Canoy D, Drøyvold W, Eriksson JG, Forsén T, Gunnarsdottir I, Järvelin MR, Koupil I, Lapidus L, Nilsen TI, Olsen SF, Schack-Nielsen L, Thorsdottir I, Tuomainen TP, Sørensen TI, NordNet Study Group. Birth weight and systolic blood pressure in adolescence and adulthood: meta-regression analysis of sex- and age-specific results from 20 Nordic studies. Am J Epidemiol. 2007; 15; 166(6):634–45.

    Google Scholar 

  10. Risnes KR, Vatten LJ, Baker JL, Jameson K, Sovio U, Kajantie E, Osler M, Morley R, Jokela M, Painter RC, Sundh V, Jacobsen GW, Eriksson JG, Sørensen TI, Bracken MB. Birthweight and mortality in adulthood: a systematic review and meta-analysis. Int J Epidemiol. 2011; 15.

  11. Silva IdS, Stavola BD, McCormack V. Collaborative group on pre-natal risk factors and subsequent risk of breast cancer 2008 birth size and breast cancer risk: re-analysis of individual participant data from 32 studies. PLoS Med. 2008;5(9):e193. doi:10.1371/journal.pmed.0050193.

    Article  Google Scholar 

  12. Kajantie E, Osmond C, Barker DJP, Forsén T, Phillips DIW, Eriksson JG. Size at birth as a predictor of mortality in adulthood: a follow-up of 350 000 person-years. Int J Epidemiol. 2005;34(3):655–63.

    PubMed  Article  Google Scholar 

  13. Reddy UM, Laughon SK, Sun L, Troendle J, Willinger M, Zhang J. Prepregnancy risk factors for antepartum stillbirth in the United States. Obstet Gynecol. 2010;116(5):1119–26.

    PubMed  Article  Google Scholar 

  14. Wingate MS, Barfield WD. Racial and ethnic variations in temporal changes in fetal deaths and first day infant deaths. Matern Child Health J. 2010;. doi:10.1007/s10995-010-0665-9.

    Google Scholar 

  15. Baldwin LM, Grossman DC, Murowchick E, Larson EH, Hollow WB, Sugarman JR, Freeman WL, Hart LG. Trends in perinatal and infant health disparities between rural American Indians and Alaska natives and rural Whites. Am J Public Health. 2009;99(4):638–46.

    PubMed  Article  Google Scholar 

  16. Mathews MS, MacDorman MF. Infant mortality statistics from the 2005 period linked birth/infant death data set. Natl Vital Stat Rep. 2008;57:1–32.

    PubMed  CAS  Google Scholar 

  17. Martin JA, Kochanek KD, Strobino DM, Guyer B, MacDorman MF. Annual summary of vital statistics-2003. Pediatrics. 2005;115(3):619–34.

    PubMed  Article  Google Scholar 

  18. Sparks JP. One size does not fit all: an examination of low birthweight disparities among a diverse set of ethnic/racial groups. Matern Child Health J. 2009;13(6):769–79.

    Article  Google Scholar 

  19. Alexander GR, Wingate MS, Boulet S. Pregnancy outcomes of American Indians: contrasts among regions and with other ethnic groups. Matern Child Health J. 2008;12(Suppl 1):5–11.

    PubMed  Article  Google Scholar 

  20. 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):1977–83.

    PubMed  Article  CAS  Google Scholar 

  21. Mc Elrath TF, Allred EN, Kubun K, Hecht JL, Onderdonk A, O’Shea TM, Paneth N, Levinton A. ELGAN Study Investigators. Factors associated with small head circumference at birth among infants born before the 28th week. Am J Obstet Gynecol. 2010;203(2):138 e 1–18.

    Article  Google Scholar 

  22. Krauss MJ, Morrissey AE, Winn HN, Amon E, Leet TL. Microcephaly: an epidemiologic analysis. Am J Obstet Gynecol. 2003;188(6):1484–9; discussion 1489–90.

    Google Scholar 

  23. Burris HH, Collins JW Jr. Race and preterm birth–the case for epigenetic inquiry. Ethn Dis. 2010;20(3):296–9.

    PubMed  Google Scholar 

  24. Bryant AS, Worjoloh A, Caughey AB, Washington AE. Ethnic/racial disparities in obstetric outcomes and care: prevalence and determinants. Am J Obstet Gynecol. 2010;202(4):335–43.

    PubMed  Article  Google Scholar 

  25. Gardosi J. Ethnic differences in fetal growth. Ultrasound Obstet Gynecol. 1995;6(2):73–4.

    PubMed  Article  CAS  Google Scholar 

  26. Grundy MF, Hood J, Newman GB. Birth weight standards in a community of mixed racial origin. Br J Obstet Gynaecol. 1978;85(7):481–6.

    PubMed  Article  CAS  Google Scholar 

  27. Ribando Seelke, C. Afro-Latinos in Latin America and considerations for US Policy Washington, D.C.: Congressional Research Service Report for Congress RL32713, 2008. http://www.fas.org/sgp/crs/row/RL32713.pdf.

  28. Giuffrida A. Racial and ethnic disparities in health in Latin America and the Caribbean: a survey, 1-22. In: Giuffrida A, editor. Racial and Ethnic Disparities in Latin America and the Caribbean. Interamerican Development Bank; 2007. http://idbdocs.iadb.org/wsdocs/getdocument.aspx?docnum=1148586. Accessed on 6 May 2011.

  29. Hall G, Patrinos HA. Indigenous peoples, poverty and human development in Latin America. London: Palgrave Macmillan; 2006.

    Google Scholar 

  30. Montenegro RA, Stephens C. Indigenous health in Latin America and the Caribbean. Lancet. 2006;367:1859–69.

    PubMed  Article  Google Scholar 

  31. Casas JA, Dachs JNW, Bambas A. Health disparities in Latin American and the Caribbean: the role of social and economic determinants. In: Equity and health: views from the Pan American Sanitary Bureau. Washington: Pan American Health Organization; 2001. (Occasional Publication No. 8). http://www.paho.org/English/DBI/Op08_03.pdf.

  32. United Nations Economic and Social Council, Permanent Forum on Indigenous Issues, Fifth Session. “Action Programme for Second Indigenous Decade Launched.” 15 May 2006. http://www.un.org/News/Press/docs/2006/hr4888.doc.htm. Accessed on 1 May 2011.

  33. Dulitsky AE. A region in denial: racial discrimination and racism in Latin America. In: Dzidzienyo A, Oboler S, editors. Neither friends nor enemies. Afro-Latinos Palgrave Macmillan: Latinos Blacks; 2005. p. 39–60.

    Google Scholar 

  34. Hughes J. Gender, equity, and indigenous women’s health in the Americas. PAHO, 2004. http://www.paho.org/English/ad/ge/IndigenousWomen-Hughes0904.pdf. Accessed on 5 Jun 2011.

  35. Matijasevich A, Victora CG, Barros AJ, Santos IS, Marco PL, Albernaz EP, Barros FC. Widening ethnic disparities in infant mortality in southern Brazil: comparison of 3 birth cohorts. Am J Public Health. 2008;98(4):692–8.

    PubMed  Article  Google Scholar 

  36. Amigo H, Bustos P, Kaufman JS. Absence of disparities in anthropometric measures among Chilean indigenous and non-indigenous newborns. BMC Public Health. 2010;10:392.

    PubMed  Article  Google Scholar 

  37. Inter-Agency Consultation on Race in Latin America (IAC). “Inter-American Dialogue Race Report.” Inter-American Dialogue. 2003. www.iac-race.org. Accessed on 5 Jan 2011.

  38. Central Intelligence Agency (CIA). The World Factbook. South America. Ecuador https://www.cia.gov/library/publications/the-worldfactbook/geos/ec.html. Accessed on 5 Jan 2011.

  39. Freytag MV, Giuffrida A, Bernal R, Cárden M. Racial and Ethnic Disparities in Health in Latin America and the Caribbean. Interamerican Development Bank, 09/28/2007. http://www.iadb.org/document.cfm?id=1148586. Accessed on 28 Mar 2011.

  40. Instituto Nacional de Estadistica y Censo (INEC). Datos Preliminaries Censo de Poblacion y Vivienda 2010. http://www.inec.gob.ec/preliminares/somos.html. Accessed on 5 May 2011.

  41. Pan American Health Organization (PAHO) and the Economic Commission for Latin America (ECLA), through the CELADE-Populations Division, and the Work Plan 2009 CEPAL/CELADE-UNFPA. Mortalidad infantil y en la niñez de pueblos indígenas y afrodescendientes de América Latina: Inequidades estructurales, patrones diversos y evidencia de derechos no cumplidos. http://new.paho.org/hq/index.php?option=com_content&task=view&id=2827&Itemid=965. Accessed on 5 Mar 2011.

  42. PAHO. Health in the Americas, 2007. vol II, Ecuador, pp, 305–321. http://www.paho.org/hia/archivosvol2/paisesing/Ecuador%20English.pdf. Accessed on 29 Apr 2011.

  43. Pan American Health Organization. Health systems profile Ecuador. Monitoring and Analysis Health Systems Change/Reform., 3rd ed.; 2008.

  44. Sistema Integrado de Indicadores Sociales del Ecuador (SIISE). Informe Social 2003, Desarrollo social y pobreza en el Ecuador, 1990–2001. http://www.siise.gov.ec/Publicaciones/2inf9.pdf. Accessed on 20 Apr 2011.

  45. Garcia-Aracil A, Winter C. Gender and ethnicity differentials in school attainment and labor market earnings in Ecuador. World Dev. 2006;34(2):289–307.

    Article  Google Scholar 

  46. Ponce J. Más Allá de los Promedios, Afrodescendientes en América Latina: Los Afroecuatorianos, World Bank Report, February 2006. http://siteresources.worldbank.org/INTLACAFROLATINSINSPA/Resources/ECUADOR_final.pdf. Accessed on 1 May 2011.

  47. de la Torre C. Everyday forms of racism in contemporary Ecuador: the experiences of middle-class Indians. Ethn Racial Stud. 2001;22(1):92–112. doi:10.1080/014198799329602.

    Article  Google Scholar 

  48. Rahier JM. Blackness, the racial/spatial order, migrations, and Miss Ecuador 1995–96. Am Anthropol. 1998;100(2):421–30.

    Article  Google Scholar 

  49. Anselmi M, Avanzini F, Moreira JM, Montalvo G, Armani D, Prandi R, Marquez M, Caicedo C, Colombo F, Tognoni G. Treatment and control of arterial hypertension in a rural community in Ecuador. Lancet. 2003; 5; 361(9364):1186–7.

    Google Scholar 

  50. Guderian RH, Guzman JR, Calvopiña M, Cooper P. Studies on a focus of yaws in the Santiago Basin, province of Esmeraldas, Ecuador. Trop Geogr Med. 1991;43(1–2):142–7.

    PubMed  CAS  Google Scholar 

  51. Weigel MM, Castro NP, Cevallos W, Tapia M. The reproductive health and practices of ethnic minority women in a South American population. Women Cancer. 2000;1(5):12–24.

    Google Scholar 

  52. Weigel MM, Castro NP. The food acquisition, dietary practices, and nutritional status of minority women of African descent living in tropical South America. Ecol Food Nutr. 2000;19:135–67.

    Article  Google Scholar 

  53. Romero-Sandoval N, Flores O, Sánchez-Pérez HJ, Sánchez-Pérez I, Martín-Mateo M. Pulmonary tuberculosis in an indigenous community in the mountains of Ecuador. Int J Tuberc Lung Dis. 2007;11:550–5.

    PubMed  CAS  Google Scholar 

  54. Rodriguez A, Guamán G, Nelson DP. Vitamin A status of children in five Ecuadorian provinces. Bull Pan Am Health Organ. 1996;30(3):234–41.

    PubMed  CAS  Google Scholar 

  55. Blackwell AD, Pryor G, Pozo J, Tiwia W, Sugiyama LS. Growth and market integration in Amazonia: a comparison of growth indicators between Shuar, Shiwiar, and nonindigenous school children. Am J Hum Biol. 2009;21(2):161–71.

    PubMed  Article  Google Scholar 

  56. Pan WK, Erlien C, Bilsborrow RE. Morbidity and mortality disparities among colonist and indigenous populations in the Ecuadorian Amazon. Soc Sci Med. 2010;70(3):401–11.

    Article  Google Scholar 

  57. El Centro de Estudios de Población y Desarrollo Social Ecuador (CEPAR). Situacion de Salud de los Pubelos Indigenas en el Ecuador, 2006. http://www.cepar.org.ec/endemain_04/nuevo06/indice.htm. Accessed on 7 May 2011.

  58. Guerrero C. Población Indígena y Afroecuatoriana en el Ecuador: a partir de la información censal de 2001. Pueblos indígenas y afrodescendientes de América Latina y el Caribe: Relevancia y Pertenencias de la información sociodemográfica para políticas y programas, CEPAL, Santiago de Chile, 2005. http://www.eclac.org/celade/noticias/paginas/7/21237/FGuerrero.pdfAccessed on 28 Apr 2011.

  59. López-Cevallos DF, Chi C. Health care utilization in Ecuador: a multilevel analysis of socioeconomic determinants and inequality issues. Health Policy Plan. 2010;25(3):209–18.

    PubMed  Article  Google Scholar 

  60. El Centro de Estudios de Población y Desarrollo Social Ecuador. Encuesta Demográfica y de Salud Materna e Infantil (ENDEMAIN) 2004. http://www.cepar.org.ec/endemain_04/nuevo05/indice.htm. Accessed on 6 May 2011.

  61. Paredes I, Hidalgo L, Chedraui P, Palma J, Eugenio J. Factors associated with inadequate prenatal care in Ecuadorian women. Int J Obstet Gyn. 2005;88(2):168–72.

    Article  CAS  Google Scholar 

  62. Eggleston E, Tsui AO, Kotelchuck M. Unintended pregnancy and low birthweight in Ecuador. Am J Public Health. 2001;91(5):808–10.

    PubMed  Article  CAS  Google Scholar 

  63. Barreno G, Lascano Y, Mosquera L, Weigel MM, Caiza ME, Cuesta P. Comparación del crecimiento intrauterino entre los recien nacidos a termino de madres adolescentes y adultas. Revista Ecuatoriana de Pediatria. 2000;1(1):4–12.

    Google Scholar 

  64. Hidalgo LA, Chendraui PA, Chavez MJ. Obstetrical and neonatal outcome in young adolescents of low socio-economic status: a case control study. Arch Gynecol Obstet. 2005;271:207–11. doi:10.1007/s00404-004-0600-7.

    PubMed  Article  Google Scholar 

  65. Caiza ME, Weigel MM, Leon L, Aguinaga R, Rubio E, et al. Recién nacido de peso elevado para edad gestacionaria. Invest Rev Ateroscler. 1996;4(2):108–14.

    Google Scholar 

  66. Weigel MM, Caiza ME, Lascano J, et al. The nausea and vomiting of early pregnancy in a high-altitude Andean population. Int J Gyn Obstet. 2000;69:9–21.

    Article  CAS  Google Scholar 

  67. Weigel MM, Calle A, Vega M, et al. The effect of chronic intestinal parasitic infection on maternal-perinatal outcome. Int J Gyn Obstet. 1996;52:9–17.

    Article  CAS  Google Scholar 

  68. Weigel MM, Narvaez WM, Lopez A, et al. Prenatal diet, nutrient intake, and pregnancy outcome in an urban Ecuadorian population. Archivos Latinoamericanos de Nutrición. 1991;26(1):21–37.

    Google Scholar 

  69. Weigel MM, Caiza ME, Castro NP, et al. Is the nausea and vomiting of early pregnancy really feto-protective? J Perinat Med. 2006;34(2):115–22.

    PubMed  Google Scholar 

  70. Khoury MJ, Berg CJ, Calle EE. The ponderal index in term newborn siblings. Am J Epidemiol. 1990;132(3):576–83.

    PubMed  CAS  Google Scholar 

  71. Ashwal S, Michelson D, Plawner L, Dobyns WD. Practice committee of the child neurology society subcommittee of the American Academy of Neurology and the evidence-based review): report of the quality standards practice parameter: evaluation of the child with microcephaly. Neurology. 2009;73:887–97.

    PubMed  Article  Google Scholar 

  72. Rimol LM, Agartz I, Djurovic S, Brown AA, Roddey JC, Kähler AK, Mattingsdal M, Athanasiu L, Joyner AH, Schork NJ, Halgren E, Sundet K, Melle I, Dale AM, Andreassen OA; Alzheimer’s disease neuroimaging initiative. Sex-dependent association of common variants of microcephaly genes with brain structure. Proc Natl Acad Sci USA. 2010; 5;107(1):384–8.

    Google Scholar 

  73. Cao XY, Jiang XM, Dou ZH, Rakeman MA, Zhang ML, O’Donnell K, Ma T, Amette K, DeLong N, DeLong GR. Timing of vulnerability of the brain to iodine deficiency in endemic cretinism. N Engl J Med. 1994;331(26):1739–44.

    PubMed  Article  CAS  Google Scholar 

  74. Shefali AK, Kavitha M, Deepa R, Mohan V. Pregnancy outcomes in pre-gestational and gestational diabetic women in comparison to non-diabetic women–a prospective study in Asian Indian mothers (CURES-35). J Assoc Physicians India. 2006;54:613–8.

    PubMed  CAS  Google Scholar 

  75. National Institute of Neurological Disorders and Stroke (NINDS). Microcephaly 2008. http://www.ninds.nih.gov/disorders/microcephaly/microcephaly.htm.

  76. González-Andrade F, López-Pulles R. Ecuador: public health genomics. Public Health Genomics. 2010;13(3):171–80.

    PubMed  Article  Google Scholar 

  77. Stoler-Poria S, Lev D, Schweiger A, Lerman-Sagie T, Malinger G. Developmental outcome of isolated fetal microcephaly. Ultrasound Obstet Gynecol. 2010;36(2):154–8.

    PubMed  Article  CAS  Google Scholar 

  78. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Mathews TJ, Kirmeyer S. Osterman MJ Births: final data for 2007. Natl Vital Stat Rep. 2010;58(24):1–85.

    PubMed  Google Scholar 

  79. Gunnarsdottir I, Birgisdottir BE, Benediktsson R, Gudnason V, Thorsdottir I. Relationship between size at birth and hypertension in a genetically homogeneous population of high birth weight. J Hypertens. 2002;20(4):623–8.

    PubMed  Article  CAS  Google Scholar 

  80. Khoury MJ, Erickson JD, Cordero JF, McCarthy BJ. Congenital malformations and intrauterine growth retardation: a population study. Pediatrics. 1988;82:83–90.

    PubMed  CAS  Google Scholar 

  81. Arteaga J, Luna L, Mutchinick OM. Diabetes, pregnancy and birth defects. Rev Invest Clin. 2008;60(2):107–14.

    PubMed  Google Scholar 

  82. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87:4–14.

    PubMed  Article  CAS  Google Scholar 

  83. Pan American Health Organization (PAHO). Regional Core Health Data System—Country Profile: ECUADOR, Annual Report from PAHO Director, 2007–2008. http://www.paho.org/english/sha/prflecu.htm.

  84. Ministerio de Salud Publica. Direccion Provincial de Salud Pichincha. Reporte SIVAN 2010.

  85. Office of the United Nations High Commissioner for Refugees. Minority Rights Group International, World Directory of Minorities and Indigenous Peoples—Ecuador : Overview, July 2008, available at: http://www.unhcr.org/refworld/docid/4954ce3223.html. Accessed 13 May 2011.

Download references

Acknowledgments

This study could not have been carried without the excellent technical assistance and dedication of the following pediatric staff, their institutions, and the Federación Ecuatoriana de Pediatría. The individual study collaborators include: Dr. Gonzalo Arcos E., Dra. Verónica Jara Ramírez, Dr. Luis Poma Cisneros, Dr. Diego Jirón, Dr. Leonel Melo Gordillo, Dra. Verónica Gutiérrez Durán, Dr. Javier Cuesta, Dr. Luis Nuñez, Dra. Soraida Davila, Dra. Cecilia Cevallos, Dr. Félix Campoverde, Dr. Walter Caicedo, Dra. María Inga, Dr. Carlos Coronel Almeida, Dra. Andrea Melo, Dr. Rosario Ramírez, Dra. Guadalupe Reyes, Dra. Paulina Proaño, Dra. Kattya Bracero Velasco, Dra. Ruth Mayorga Vallejo, Dr. Pablo Olmedo Ayala, Dr. Xavier Cando, Dra. María Fernanda Cárdenas, Dra. Laura Espinoza Ortiz, Dr. Néstor de la Torre, Dr. Eberth Castro, Dr. Misael Olalla, Dra. Inés Fernández Fernández, Dra. Nery Yánez Medina, Dra. Brenda Lamilla Engracia, Dra. Jeaneth Pazmiño, Dra. Jeaneth González Ayala, Dra. Mónica Cevallos Noroña, Dra. Fabiola Males Jácome, Dr. Edison Tamayo Orquera, Dra. Carmen Quishpe Zagal, Dra. Fanny Logroño, Dr. Armando Vilca Molina, Dr. José Paredes Benítes, Dr. Carlos Fernando Vaca Pazmiño, Dra. Mariana Proaño, Dra. Irma Cando, Dra. Laura Narvaez, Dr. Patricio Reina, Dr. César Alulema Velasco, and Dra. Gabriela Alexandra Brito Carrillo.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Margaret Weigel.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s10903-016-0470-7.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Margaret Weigel, M., Sanchez, M.E.C. Ethnic/Racial Disparities in the Fetal Growth Outcomes of Ecuadorian Newborns. J Immigrant Minority Health 15, 198–206 (2013). https://doi.org/10.1007/s10903-011-9571-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-011-9571-5

Keywords

  • Fetal growth disparities
  • Pregnancy outcome
  • Microcephaly
  • Ponderal index
  • Low birth weight
  • Minority women