181382 Does the Epidemiologic Paradox Hold in the Presence of Risk Factors for Low Birth Weight Infants Among Mexican-born Women in Colorado?

Monday, October 27, 2008: 12:30 PM

Jodi K. Duke, MPH candidate , Preventive Medicine and Biometrics, University of Colorado, Health Sciences Center, Denver, CO
Camila X. Romero, MD , Preventive Medicine and Biometrics, University of Colorado, Health Sciences Center, Denver, CO
Dana Dabelea, MD, PhD , Preventive Medicine and Biometrics, University of Colorado, Health Sciences Center, Denver, CO
Lorraine G. Ogden, PhD , Preventive Medicine and Biometrics, University of Colorado, Health Sciences Center, Denver, CO
     
OBJECTIVES: This study examines whether foreign-born status confers a protective effect against having low birth weight (LBW) infants among women of Mexican origin in Colorado, and whether this protection persists in the presence of maternal risk factors.

METHODS: This retrospective cohort study utilized Colorado birth records between 1989 and 2004 for multivariate logistic regression analysis. The study population consisted of 66,422 US-born women of Mexican origin (USB) and 85,000 Mexican-born (MB) women with singleton births.

RESULTS: MB women had 24.9% lower odds of having LBW infants (OR 0.751, 95% CI 0.72-0.78) than USB women. MB women had a higher overall prevalence of medical risk factors for LBW infants than their USB counterparts (anemia 6.53% vs. 2.4%, cardiac disease 0.24% vs. 0.16%, and chronic hypertension 0.39% vs. 0.32%, respectively p<=0.05). MB women also had higher prevalence in both inadequacy of and absence of prenatal care (14.6% vs. 7.9% and 1.7% vs. 1.5%, respectively, p<=.0001), and a higher prevalence of less-than-high-school education (68.6% vs. 35.4%, p<=.0001). After adjusting for the aforementioned maternal risk factors, MB women still had 22% lower odds of having LBW infants (OR 0.77, 95% CI 0.73-0.81) than USB women.

CONCLUSIONS: These findings lend support to the epidemiologic paradox in Colorado: despite a higher prevalence of maternal medical and socioeconomic risk factors, Mexican-born status confers an overall protective effect against having LBW infants. Further research is needed to test the underlying mechanisms that are responsible for this protection.

Learning Objectives:
1. Describe maternal risk factors for low birth weight outcomes and the adverse consequences of low birth weight for the infant. 2. Articulate the relationship between foreign-born status and low birth weight outcomes among women of Mexican origin. 3. Identify the "epidemiologic paradox" as a prevalent concept in immigrant health and discuss the underlying mechanisms for the relationship of foreign-born status and low birth weight outcomes for future research.

Keywords: Maternal and Child Health, Immigrant Women

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I worked on the planning/creation of the research question, logistic regression analysis, literature review for the background/introduction, and wrote the content of this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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