Yang Yanchao, Fujii Sota, Nguyen Thinh
School of Business and Leadership, DePauw University, Greencastle, IN 46135, USA.
Int J Environ Res Public Health. 2025 Aug 26;22(9):1325. doi: 10.3390/ijerph22091325.
Infants born to mothers who self-identify as Hispanic account for a substantial and growing share of births in the United States, yet limited research has examined disparities in birth outcomes across Hispanic origin subgroups. This study aims to document trends and identify important factors associated with Cesarean section (C-section), low birthweight, and prematurity within the Hispanic population. We use data from the National Vital Statistics System (2011-2021), covering nearly all U.S. births. We compare outcomes across Hispanic, non-Hispanic White, and non-Hispanic Black mothers and further disaggregate by Hispanic origin (Mexican, Puerto Rican, Cuban, Central/South American, and Other/Unknown). We use logistic regression and classification tree models to assess associations between maternal, infant, and clinical factors and birth outcomes. We find that Hispanic mothers have birth outcomes similar to non-Hispanic Whites and better than non-Hispanic Blacks. However, prematurity rates among Hispanics have slightly increased over time. Mexican mothers exhibit the most favorable outcomes, while Cuban mothers show higher rates of C-section, and Puerto Rican mothers show higher rates of low birthweight and prematurity. Logistic regression results highlight multiple births, breech presentation, and hypertensive conditions as important factors associated with adverse birth outcomes. Our biomedical approach emphasizes physiological and clinical risk factors such as multiple births, breech presentation, hypertensive conditions, and obesity. In parallel, our biosocial analysis incorporates demographic, socioeconomic, and behavioral variables to contextualize how social determinants interact with biology to influence outcomes. Complementing these findings, our classification tree analysis identifies inadequate gestational weight gain (less than 15 pounds) as a prominent risk factor for both low birthweight and prematurity. Additionally, obesity emerges as a significant factor linked to an increased likelihood of C-section. While birth outcomes among Hispanic mothers are generally favorable, subgroup differences and emerging disparities highlight the need for disaggregated research and culturally tailored public health interventions.
自我认定为西班牙裔的母亲所生的婴儿在美国出生人口中占相当大且不断增长的比例，但针对西班牙裔不同亚组出生结局差异的研究有限。本研究旨在记录趋势，并确定西班牙裔人群中与剖宫产、低出生体重和早产相关的重要因素。我们使用了国家生命统计系统（2011 - 2021年）的数据，涵盖了几乎所有美国出生人口。我们比较了西班牙裔、非西班牙裔白人及非西班牙裔黑人母亲的分娩结局，并按西班牙裔血统（墨西哥裔、波多黎各裔、古巴裔、中/南美洲裔以及其他/不明）进一步细分。我们使用逻辑回归和分类树模型来评估孕产妇、婴儿和临床因素与出生结局之间的关联。我们发现，西班牙裔母亲的出生结局与非西班牙裔白人相似，且优于非西班牙裔黑人。然而，随着时间推移，西班牙裔人群中的早产率略有上升。墨西哥裔母亲的分娩结局最为理想，而古巴裔母亲的剖宫产率较高，波多黎各裔母亲的低出生体重和早产率较高。逻辑回归结果突出了多胞胎、臀位分娩和高血压状况是与不良出生结局相关的重要因素。我们的生物医学方法强调诸如多胞胎、臀位分娩、高血压状况和肥胖等生理和临床风险因素。同时，我们的生物社会分析纳入了人口统计学、社会经济和行为变量，以阐明社会决定因素如何与生物学相互作用来影响结局。作为这些发现的补充，我们的分类树分析确定孕期体重增加不足（少于15磅）是低出生体重和早产的一个突出风险因素。此外，肥胖成为与剖宫产可能性增加相关的一个重要因素。虽然西班牙裔母亲的出生结局总体良好，但亚组差异和新出现的差异凸显了进行细分研究和开展符合文化特点的公共卫生干预措施的必要性。
