Kelaher Margaret, Jessop Dorothy Jones
Medical and Health Research Association of New York City, Inc, New York, USA.
Soc Sci Med. 2002 Dec;55(12):2171-5. doi: 10.1016/s0277-9536(01)00360-4.
In the USA foreign-born women tend to have fewer low-birthweight births than US-born women from the same ethnicity. This "healthy migrant" effect could be caused by immigration of the fittest or by healthy people being deliberately selected in the immigration process. This study tests these hypotheses by comparing self-reported history of low-birth-weight among foreign-born documented and undocumented Latinas and US-born Latinas. The sample includes 2398 (57.5%) documented foreign-born Latinas, 782 (18.7%) undocumented foreign-born Latinas, and 993 (23.4%) US-born Latinas who initiated prenatal care at MIC-Women's Health Services/MHRA in New York City during 1996-1997. Only women who reported previous live births were included in the sample. Documented foreign-born Latinas were less likely than US-born Latinas to have low-birth-weight babies taking into account parity, age, risk, and education. There were no significant differences between rates of low-birthweight for undocumented foreign-born Latinas and US-born Latinas, or documented foreign-born Latinas. There was, however, a significant trend for rates of low-birthweight to increase from documented foreign-born to undocumented foreign-born to US-born women. This suggests that both official screening and migration of the fittest play a role in lower rates of low-birthweight among foreign-born Latinas compared to US-born Latinas.
在美国,外国出生的女性往往比同种族的美国本土女性低体重儿出生数量更少。这种“健康移民”效应可能是由最健康者的移民造成的,也可能是在移民过程中健康人群被刻意挑选所致。本研究通过比较外国出生的有文件证明和无文件证明的拉丁裔女性以及美国出生的拉丁裔女性自我报告的低体重出生史,来检验这些假设。样本包括1996年至1997年期间在纽约市MIC妇女健康服务中心/ MHRA开始产前护理的2398名(57.5%)有文件证明的外国出生的拉丁裔女性、782名(18.7%)无文件证明的外国出生的拉丁裔女性和993名(23.4%)美国出生的拉丁裔女性。样本仅包括报告有过活产的女性。考虑到胎次、年龄、风险和教育程度,有文件证明的外国出生的拉丁裔女性比美国出生的拉丁裔女性生下低体重儿的可能性更小。无文件证明的外国出生的拉丁裔女性与美国出生的拉丁裔女性或有文件证明的外国出生的拉丁裔女性的低体重儿出生率之间没有显著差异。然而,从有文件证明的外国出生女性到无文件证明的外国出生女性再到美国出生的女性,低体重儿出生率有显著上升趋势。这表明,与美国出生的拉丁裔女性相比,官方筛查和最健康者的移民都在外国出生的拉丁裔女性较低的低体重儿出生率中发挥了作用。