在科罗拉多州出生的墨西哥裔女性中，低体重儿的风险因素存在时，流行病学悖论是否成立？
Does the epidemiologic paradox hold in the presence of risk factors for low birth weight infants among Mexican-born women in Colorado?
作者信息
Romero Camila X, Duke Jodi K, Dabelea Dana, Romero Tomas E, Ogden Lorraine G
机构信息
Colorado School of Public Health, Preventive Medicine Residency Program, USA.
出版信息
J Health Care Poor Underserved. 2012 May;23(2):604-14. doi: 10.1353/hpu.2012.0065.
OBJECTIVES
To test whether foreign-born status confers a protective effect against low birth weight (LBW) outcomes among Mexican-origin women in Colorado.
METHODS
Retrospective cohort study utilizing Colorado birth records from 1989-2004 for multivariate logistic regression analysis. The study population was 66,422 U.S.-born women of Mexican origin (USB) and 85,000 Mexican-born (MB) women with singleton births.
RESULTS
Mexican-born women had 24.9% lower odds of LBW (OR 0.751 95% CI 0.782) than USB women. Mexican-born women had a higher prevalence of risk factors for LBW than their USB counterparts (anemia, cardiac disease, hypertension, inadequate prenatal care, less than high school education). After adjusting for these risk factors, MB women had 22.5% lower odds of having LBW infants than USB women (OR 0.775, 95% CI 0.73-0.81).
CONCLUSIONS
This study supports the epidemiologic paradox of LBW; despite higher prevalence of risk factors, foreign-born status confers an overall protective effect against low birth weight outcomes.
目的
检验在科罗拉多州的墨西哥裔女性中，外国出生状态是否对低出生体重（LBW）结局具有保护作用。
方法
采用回顾性队列研究，利用1989 - 2004年科罗拉多州的出生记录进行多因素逻辑回归分析。研究人群为66422名美国出生的墨西哥裔女性（USB）和85000名单胎出生的墨西哥出生女性（MB）。
结果
墨西哥出生的女性发生低出生体重的几率比美国出生的女性低24.9%（比值比0.751，95%置信区间0.782）。墨西哥出生的女性比美国出生的女性具有更高的低出生体重危险因素患病率（贫血、心脏病、高血压、产前护理不足、高中以下学历）。在对这些危险因素进行调整后，墨西哥出生的女性生出低出生体重婴儿的几率比美国出生的女性低22.5%（比值比0.775，95%置信区间0.73 - 0.81）。
结论
本研究支持低出生体重的流行病学悖论；尽管危险因素患病率较高，但外国出生状态对低出生体重结局具有总体保护作用。
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