School of Medicine, University of Utah, Salt Lake City, UT 84112, USA.
Womens Health Issues. 2012 Sep;22(5):e501-7. doi: 10.1016/j.whi.2012.07.005.
The "Latina epidemiologic paradox" postulates that despite socioeconomic disadvantages, Latina mothers have a lower risk for delivering low birth weight (LBW) babies than non-Latina Whites. However, these patterns may be changing over time and may differ depending on the mother's birthplace and legal status in the United States. This study investigates differences in risk for three birth outcomes among Whites, U.S.-born Latinas, and foreign-born Latinas.
We undertook a cross-sectional study of rates of LBW, preterm, and small-for-gestational-age (SGA) births among 196,617 women delivering live, singleton births in Utah from 2004 to 2007. Each group was compared using logistic regression.
U.S.-born Latinas had a similar or greater risk for all three outcomes when compared with Whites. Foreign-born Latinas had lower risk for preterm birth (odds ratio [OR], 0.85; 95% confidence interval [CI], 0.80-0.90) compared with Whites, but not for LBW and SGA; foreign-born Latinas had a lower risk for LBW (OR, 0.82; 95% CI, 0.74-0.92), preterm birth (OR, 0.81; 95% CI, 0.74-0.89), and SGA (OR, 0.91; 95% CI, 0.83-0.99) compared with U.S.-born Latinas. Among foreign-born Latinas only, there was no difference in risk between documented (i.e., those who had a legal social security number) and undocumented women for LBW, preterm birth, or SGA.
These data support the existence of a variation of the "Latina paradox" among Latinas according to birthplace, where U.S.-born Latinas do not experience better birth outcomes than Whites, but foreign-born Latinas experience better birth outcomes for several endpoints compared with U.S.-born Latinas. Prevention efforts may prove more effective by considering the different composition of risk factors among foreign- and U.S.-born Latina populations.
“拉丁裔流行病学悖论”假设，尽管存在社会经济劣势，拉美裔母亲所生的低出生体重儿（LBW）的风险低于非拉美裔白人。然而，这些模式可能随着时间的推移而发生变化，并且可能因母亲在美国的出生地和法律地位而有所不同。本研究调查了白人、在美国出生的拉丁裔和在外国出生的拉丁裔之间三种分娩结果的风险差异。
我们对 2004 年至 2007 年期间在犹他州分娩的 196617 名单胎活产妇女的 LBW、早产和小于胎龄儿（SGA）的发生率进行了横断面研究。使用逻辑回归比较每组。
与白人相比，在美国出生的拉丁裔在所有三种结果中都有相似或更大的风险。与白人相比，外国出生的拉丁裔早产的风险较低（比值比[OR]，0.85；95%置信区间[CI]，0.80-0.90），但 LBW 和 SGA 除外；外国出生的拉丁裔 LBW 的风险较低（OR，0.82；95%CI，0.74-0.92），早产（OR，0.81；95%CI，0.74-0.89）和 SGA（OR，0.91；95%CI，0.83-0.99）与在美国出生的拉丁裔相比。仅在外国出生的拉丁裔中，有记录（即拥有合法社会安全号码的人）和无记录的妇女在 LBW、早产或 SGA 方面的风险没有差异。
这些数据支持根据出生地存在“拉丁裔悖论”的变化，在美国出生的拉丁裔的分娩结果并不优于白人，但与在美国出生的拉丁裔相比，外国出生的拉丁裔在多个终点的分娩结果更好。考虑到外国出生和美国出生的拉丁裔人群中风险因素的不同组成，预防工作可能会更有效。
