DeCamp Lisa Ross, Choi Hwajung, Fuentes-Afflick Elena, Sastry Narayan
Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA,
Matern Child Health J. 2015 Jun;19(6):1354-63. doi: 10.1007/s10995-014-1640-7.
To compare the association between neighborhood Latino immigrant concentration and infant mortality by maternal nativity among singleton births to Mexican-origin women in Los Angeles County. Information about births, infant deaths, and infant and maternal characteristics were obtained from geocoded Los Angeles County vital statistics records (2002-2005). Linked data on neighborhood characteristics (census tracts) were obtained from the 2000 census. Logistic regression models were used to predict infant mortality while accounting for spatial clustering by census tract. Two-thirds of births to Mexican-origin mothers were to foreign-born women. Foreign-born mothers were older, had less education, and were more likely to have delivery costs paid by Medicaid than US-born mothers. Infants born to foreign-born women had a lower infant mortality rates than infants born to US-born women (3.8/1,000 live births vs. 4.6, p = .002). Among infants of foreign-born mothers, the odds of infant mortality increased with increasing immigrant concentration (OR 1.29; 95 % CI 1.01-1.66). There was a similar pattern of association between immigrant concentration and mortality for infants of US-born mothers (OR 1.29; 95 % CI 0.99-1.67). In Los Angeles County, the odds of infant mortality among foreign-born Mexican-origin Latina were higher in higher-density immigrant neighborhoods, with a similar trend among US-born mothers. Thus, living in immigrant enclaves likely does not help to explain the lower than expected infant mortality rate among infants born to Latina women. Instead, higher neighborhood Latino immigrant concentration may indicate a neighborhood with characteristics that negatively impact maternal and infant health for Latinos.
为了比较洛杉矶县墨西哥裔妇女单胎分娩中，社区拉丁裔移民集中度与按母亲出生地划分的婴儿死亡率之间的关联。有关出生、婴儿死亡以及婴儿和母亲特征的信息，来自洛杉矶县地理编码的生命统计记录（2002 - 2005年）。关于社区特征（普查区）的关联数据，来自2000年人口普查。使用逻辑回归模型预测婴儿死亡率，同时考虑普查区的空间聚类情况。墨西哥裔母亲所生的孩子中有三分之二是外国出生的女性所生。外国出生的母亲年龄更大，受教育程度更低，与美国出生的母亲相比，她们更有可能由医疗补助计划支付分娩费用。外国出生的女性所生婴儿的死亡率低于美国出生的女性所生婴儿（每1000例活产中有3.8例死亡vs. 4.6例，p = 0.002）。在外国出生母亲的婴儿中，婴儿死亡率的几率随着移民集中度的增加而增加（比值比1.29；95%置信区间1.01 - 1.66）。美国出生母亲的婴儿在移民集中度和死亡率之间也有类似的关联模式（比值比1.29；95%置信区间0.99 - 1.67）。在洛杉矶县，外国出生的墨西哥裔拉丁裔婴儿在高密度移民社区的死亡几率更高，美国出生的母亲中也有类似趋势。因此，居住在移民聚居区可能无法解释拉丁裔女性所生婴儿的死亡率低于预期的情况。相反，社区中较高的拉丁裔移民集中度可能表明该社区具有对拉丁裔母婴健康产生负面影响的特征。
