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Disadvantaged newly immigrant Hispanic women have much better birth outcomes than disadvantaged U.S. black women
Minority race and socioeconomic disadvantage for Hispanic women in the United States have not translated into rates of low birthweight and other poor pregnancy outcomes that afflict black women in this country. Rather, birth outcomes for Hispanic women are similar to or better than those for white women. This "Hispanic paradox" may be due to some protective factors of newly arrived immigrants, which may wane over time, suggest the authors of a new study.
The researchers analyzed the pregnancy outcomes of 10,755 Medicaid-insured women, who gave birth at the Duke University Medical Center between 1994 and 2004. Black women, who were younger, were more likely to have another medical condition while pregnant, to remain in the hospital for more than 4 days, and to have hospital charges over $7,500. Black women also had higher rates of preterm birth, small-for-gestational-age (SGA) infants, preeclampsia, and stillbirths. There were no racial differences in rates of gestational diabetes mellitus (GDM).
Compared with white women, Hispanic women were 34 percent less likely to have preterm births, and black women had 30 percent higher odds of preeclampsia and 74 percent higher odds of SGA infants. Since all the women were poor, Medicaid-insured patients, poverty, and insurance status did not explain these differences. Maternal overweight, GDM, and impaired glucose tolerance, common among Mexican-Americans, may provide some protection against low birthweight that might be anticipated as a result of poverty and reduced access to care.
Future studies will determine whether acculturation will lead to loss of this perinatal advantage in the underprivileged Hispanic community. The study was supported in part by the Agency for Healthcare Research and Quality (HS13353).
More details are in "The 'Hispanic paradox': An investigation of racial disparity in pregnancy outcomes at a tertiary care medical center," by Haywood L. Brown, M.D., Monique V. Chireau, M.D., M.P.H., Yhenneko Jallah, M.S., and Daniel Howard, Ph.D., in the August 2007 American Journal of Obstetrics & Gynecology 197, pp. e1-e9.
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