Extensive literature suggests that despite economic disadvantage, foreign-born women of color in the United States experience more favorable birth outcomes than US-born women of color and non-Latina white US-born women. Some studies find that after adjustment for demographics, economic or behavioral factors, the Hispanic or Latina ‘paradox’ is not sustained.

Methods

We used 2009-2019 birth certificate and survey data from the New Mexico Pregnancy Risk Assessment Monitoring System to measure the odds of low birthweight LBW (<2500 grams) and preterm birth PTB (<37 weeks gestation, obstetric estimate) in singleton infants among three populations: non-Latina white (n=3708), US-born Latina (n=4409), and foreign-born Latina women (n=1423). We used SAS version 9.4 survey procedures for weighted bivariate analysis, chi-square tests and logistic regression.

Results

After adjustment for demographic factors, US-born Latinas and non-Latina whites were each more likely to deliver a LBW infant (aOR 1.75, 1.18-2.57 and aOR 1.55, 1.05-2.33) compared to foreign-born Latinas (reference). The effect of nativity persisted in models with adjustment for medical and behavioral risks (e.g., tobacco use) and cumulative adjustment for healthcare service utilization, among US-born Latinas ( aOR 1.99, 1.28-3.09), but not for US-born non-Latina whites. Statistical differences were not observed when modeling adjusted odds for preterm birth.

Discussion

Our findings do not universally support the Latina Paradox, but they do support the idea that birth weight is more favorable for foreign-born than for US-born Latinas. Our results do not provide explanatory interpretations, and additional measures on social support may provide insight for policy implications.