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A recent study from the Harvard School of Public Health reveals that babies born to
immigrant mothers in the US face a higher risk of Low Birth Weight (LBW). The goal of this
investigation was to compare the incidence of LBW in and among Non-Hispanic Whites,
Non-Hispanic Black, and Multi-ethnic Hispanic babies born to women with varying levels of
education, and who were native to the US and foreign countries.
In 2003, The National Institute of Health established “Reducing Preterm and Low Birth
Weight in Minority Families" a top Public Health goal. With this goal in mind, this
study (data from 1998) adds to similar past studies which shed light on fundamental
processes that give rise to the differences in incidence of LBW, among and within various
ethnic groups. However, unlike past methods which included data from a few US states, and
used control groups of either US-born women who were white, or US-born women of various
other races and ethnicities, the present study included national data, and the reference
group chosen included US-born women of all ethnic backgrounds, foreign born women and
white women. Additionally, the factor of socioeconomic status was considered across all
races for immigrant and US-born mothers.
Methods
Analyses were conducted, based on statistics from 2,436, 890 usable birth records from
1998 of US-born and foreign-born mothers from all states and territories of the United
States. These analyses were then used to study the differentials in LBW by nativity, both
across racial/ethnic groups and by education level.
The outcome variable was Low Birth Weight. Demographic variables included were: maternal
age, race (or ethnicity), place of birth, marital status, and socioeconomic status
(education level). Data supplied by the mothers themselves, involving clinical risk
factors, included prenatal care, health habits (including tobacco and alcohol use), and
complications arising during pregnancy.
Results
Foreign-born status did not decrease the risk of LBW among white women. It did, however,
increase the risk among Asian women by 24%, and reduced the risk among black and Hispanic
women, by 25% and by 19% respectively.
When comparing the incidence of LBW between foreign-born mothers to US-born mothers of
various ethnicities and at the same level of educational attainment, there was a smaller
incidence of LBW among foreign-born mothers with low education than among women with more
education. Foreign-born women of all ethnicities giving birth to babies with LBW exhibited
a smaller difference in education level than mothers of the same racial backgrounds born
in the US.
Conclusions
The foreign-born status of women does affect the incidence of LBW, and the manner and
degree to which it is affected varies across racial/ethnic groups. Within these groups,
the incidence of LBW varies by level of educational attainment.
Future studies may investigate hypotheses regarding the root causes of these variations in
LBW, including health selection of immigrants, cultural factors, social support, and
social environment.
Complete findings of the study appear in Pediatrics Vol. 115 No. 1 January 2005, pp.
e20-e30
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