Cohen B B, Friedman D J, Mahan C M, Lederman R, Munoz D
Bureau of Health Statistics, Research and Evaluation, Massachusetts Department of Public Health, Boston 02111.
Public Health Rep. 1993 May-Jun;108(3):363-71.
National data reveal that low birth weight and infant mortality rates among Hispanics are, in general, between the rates for whites and those for blacks. The question remains, do differences in low birth weight reflect distributions of known risk factors, or do ethnic differences persist after simultaneously adjusting for intervening variables? In this study, Massachusetts birth certificate data for 206,973 white non-Hispanic infants and 19,571 Hispanic infants are used to examine differences in low birth weight between white non-Hispanic and Hispanic infants, as well as variation among seven subgroups of Hispanic mothers--Puerto Rican, Dominican, Central American, South American, Mexican, Cuban, and other Hispanic. Regression analysis is used to estimate the association between risk factors and birth weight and the relative risk of low birth weight. Risk factors include ethnicity, demographic characteristics, biological factors, access to prenatal care, and infants' conditions. Results indicate substantial variation in mean birth weight, low birth weight, and levels of risk among Hispanic subgroups and between Hispanics and white non-Hispanics. Puerto Rican infants had the lowest mean birth weight and, in general, the highest level of risk factors in this population. None of the adjusted odds ratios for low birth weight for any Hispanic group was significantly elevated at the 95 percent level compared with white non-Hispanics. Findings in this study confirm the previous observations of the wide variation among Hispanic subgroups and the high level of risk among Puerto Ricans. Results of this study also raise some interesting questions about the differential relationship between ethnicity and birth weight, ethnicity and low birth weight, and the significance of maternal place of birth as a proxy measure of adaptation or acculturation.
全国数据显示,西班牙裔人群的低出生体重和婴儿死亡率总体上介于白人和黑人之间。问题依然存在,低出生体重的差异是反映了已知风险因素的分布情况,还是在同时调整干预变量后种族差异仍然存在?在本研究中,利用马萨诸塞州206,973名非西班牙裔白人婴儿和19,571名西班牙裔婴儿的出生证明数据,来研究非西班牙裔白人和西班牙裔婴儿在低出生体重方面的差异,以及西班牙裔母亲的七个亚组(波多黎各裔、多米尼加裔、中美洲裔、南美洲裔、墨西哥裔、古巴裔和其他西班牙裔)之间的差异。回归分析用于估计风险因素与出生体重之间的关联以及低出生体重的相对风险。风险因素包括种族、人口统计学特征、生物学因素、获得产前护理的情况以及婴儿状况。结果表明,西班牙裔亚组之间以及西班牙裔与非西班牙裔白人之间在平均出生体重、低出生体重和风险水平方面存在显著差异。在这一群体中,波多黎各裔婴儿的平均出生体重最低,总体风险因素水平最高。与非西班牙裔白人相比,任何西班牙裔群体低出生体重的调整后优势比在95%的水平上均未显著升高。本研究结果证实了之前关于西班牙裔亚组之间差异巨大以及波多黎各裔风险水平较高的观察结果。本研究结果还提出了一些有趣的问题,涉及种族与出生体重、种族与低出生体重之间的差异关系,以及母亲出生地作为适应或文化适应的替代指标的意义。