482 - Very Low Birth Weight Among Latinx Women in the United States: Is the Paradox Lost?

Poster Number: 482
Publication Number: 482.129

Aarti Kulkarni, John H. Stroger Jr. Hospital of Cook County, Chicago, IL, United States; Helen Atkinson, none, Durham, NC, United States; Janardhan Mydam, John H Stroger Jr. Hospital of Cook County Chicago ,IL ; Rush Medical College, Chicago ,IL., Buffalo Grove, IL, United States

Background: The term “Latina paradox” refers to the observation that, despite having fewer resources, Latinx women have a similar or even lower risk for delivering low birth weight infants compared to Non-Latinx White women. It is unknown whether the paradox exists among very low birth weight (VLBW) infants.

Objective: To determine if the Latina paradox exists among VLBW infants.

Design/Methods: Our study used 2016-2019 US natality data from the National Center for Health Statistics. Rates of VLBW were calculated in Latinx, Non-Latinx White, and Non-Latinx Black women (Nf 12,621,156), with each group further stratified by nativity (foreign-born [FB] and US-born [USB]). We used nested multivariable logistic regression models, controlling for socioeconomic and health-related confounding or mediating covariates of VLBW, and calculated odds ratios (ORs) with 95% confidence intervals (CIs) for race-nativity stratified groups, using USB Non-Latinx White women as the reference group.

Results: Overall, the VLBW rate was 0.97% for Latinx women (n= 2,671,945) and 0.76% for Non-Latinx White women (n=7,738,273). When stratified by nativity, the VLBW rate was 1.03% for USB Latinas (n=1,521,232) and 0.9% for FB Latinas (n=1,150,713), both higher than the rate (0.78%) for USB Non-Latinx White women (OR:1.33; 95% CI: 1.30-1.35 for USB Latinas and OR: 1.16; 95% CI: 1.13-1.18 for FB Latinas, vs USB Non-Latinx White women as reference group). Compared to Non-Latinx White women, Latinx women were younger, less educated, and less likely to be married, with less paternal involvement, poorer prenatal care and higher rates of WIC enrollments (a proxy for poverty). However, Latinx women had generally good pregnancy health and less smoking exposure than Non-Latinx White women. Risk factors were comparable between Latinx and Non-Latinx Black women. After adjusting for covariates, compared to USB Non-Latinx White women (reference group), odds of VLBW were 45% higher for USB Latinas (OR: 1.45: 95% CI: 1.42-1.48) and 36% higher for FB Latinas (OR: 1.36; 95% CI: 1.33-1.40). Non-Latinx Black women had the highest odds (OR: 2.96; 95% CI: 2.92-3.01 for USB and OR: 2.55; 95% CI: 2.45-2.63 for FB).Conclusion(s): The Latina paradox is not observed with VLBW infants when Latinx women are compared to Non-Latinx White women, and the absence of paradox holds for both USB and FB Latinas. However, Latinas still fare much better than Non-Latinx Black women, regardless of nativity. This supports prior studies that health care disparities among minority racial and ethnic groups in the United States affect VLBW rates.
Figure 1 and corresponding table 1. Distribution of Very Low Birth Weight among Non-Latinx White, Non-Latinx Black, and Latinx Women According to Nativity (United States, 2016–2019).
Table 2. Odds Ratios for the Effect of Maternal Race and Nativity on Very Low Birth Weight Among Non-Latinx White, Non-Latinx Black, and Latinx Women, Adjusting for Different Sets of Risk Factors in Multivariable Logistic Regression Models (United States, 2016–2019).