Mydam Janardhan, David Richard J, Rankin Kristin M, Collins James W
Division of Neonatology, John H. Stroger, Jr. Hospital of Cook County, 1969 Ogden Avenue, Chicago, IL, 60612, USA.
Department of Pediatrics, University of Illinois at Chicago, 1901 West Harrison Street, Chicago, IL, 60612, USA.
Matern Child Health J. 2019 Apr;23(4):538-546. doi: 10.1007/s10995-018-2669-9.
Objectives To explore associations between race, nativity, and low birth weight (LBW) among Latina and non-Latina women, with special attention to the Black Latina subgroup. Methods Using US natality data from 2011 to 2013, we designed a population-based study to compare LBW (< 2500 g) rates across six groups of women with self-identified race (N = 7,865,264)-White and Black Latina, foreign-born and US-born; non-Latina Black; and non-Latina White-creating 4 models for analysis: unadjusted (Model 1) and adjusted for sociodemographic factors (Model 2), sociodemographic plus medical risk factors (Model 3), and Model 3 factors plus smoking (Model 4). Results Infant LBW rate for Black Latinas (7.9%) was higher than White Latinas (5.6%) and varied by nativity: US-born (8.9%) versus foreign-born (6.1%). Among all study groups, US-born Black Latinas' LBW rate (8.9%) was second only to non-Latina Blacks (11.0%). In unadjusted Model 1, US-born Black Latinas had 81% (odds ratio [OR]: 1.81; 95% confidence interval [CI]: 1.74-1.88) and foreign-born Black Latinas had 22% (OR: 1.22; 95% CI 1.15-1.29) higher odds of LBW than non-Latina White women (reference group). However, in Model 2, ORs for foreign-born Black Latinas were nearly identical to non-Latina Whites (OR: 1.03; 95% CI 0.97-1.1), while US-born Black Latinas' odds were still 47% higher (OR: 1.47; 95% CI 1.42-1.53). Model 3 ORs for each group were similar to Model 2. Conclusions for Practice A significant subgroup of Latina women self-identify as Black, and their LBW rates are higher than White Latinas. Black Latinas born in the United States fare worse than their foreign-born counterparts, implicating negative effects of Black race specific to the US context.
目的 探讨拉丁裔和非拉丁裔女性中种族、出生地与低出生体重（LBW）之间的关联，特别关注黑人拉丁裔亚组。方法 利用2011年至2013年美国出生数据，我们设计了一项基于人群的研究，比较六组自我认定种族女性（N = 7,865,264）的低出生体重（<2500克）发生率——白人及黑人拉丁裔，外国出生及美国出生；非拉丁裔黑人；以及非拉丁裔白人——构建4个分析模型：未调整模型（模型1）、根据社会人口学因素调整后的模型（模型2）、社会人口学因素加医学风险因素调整后的模型（模型3）以及模型3因素加吸烟调整后的模型（模型4）。结果 黑人拉丁裔婴儿的低出生体重率（7.9%）高于白人拉丁裔（5.6%），且因出生地而异：美国出生的（8.9%）高于外国出生的（6.1%）。在所有研究组中，美国出生的黑人拉丁裔的低出生体重率（8.9%）仅次于非拉丁裔黑人（11.0%）。在未调整的模型1中，美国出生的黑人拉丁裔发生低出生体重的几率比非拉丁裔白人女性（参照组）高81%（优势比[OR]：1.81；95%置信区间[CI]：1.74 - 1.88），外国出生的黑人拉丁裔高22%（OR：1.22；95% CI 1.15 - 1.29）。然而，在模型2中，外国出生的黑人拉丁裔的OR值与非拉丁裔白人几乎相同（OR：1.03；95% CI 0.97 - 1.1），而美国出生的黑人拉丁裔的几率仍高47%（OR：1.47；95% CI 1.42 - 1.53）。模型3中每组的OR值与模型2相似。实践结论 相当一部分拉丁裔女性自我认定为黑人，她们的低出生体重率高于白人拉丁裔。在美国出生的黑人拉丁裔比外国出生的情况更糟，这表明在美国背景下黑人种族存在负面影响。
