The Hispanic/Latinx Perinatal Paradox in the United States: A Scoping Review and Recommendations to Guide Future Research

Abstract

For decades, epidemiologists have documented a health advantage among Hispanic/Latinx individuals who live in the United States, despite their significant socioeconomic barriers. This observation is often described as the "Hispanic paradox." In this scoping review, we aimed to summarize literature published on Hispanic/Latinx perinatal outcomes over the past two decades and place these findings within the context of the overarching "Healthy Immigrant" paradox. Studies were eligible for inclusion if they utilized large population datasets to describe rates of preterm birth, low birth weight and infant mortality among Hispanic/Latinx women living in the United States. To focus on the most recent trends, studies were excluded if they were published prior to the year 2000. Globally, Hispanic/Latinx women appear to continue to have improved perinatal outcomes compared to non-Hispanic Black infants, while rates of adverse outcomes appear similar for Hispanic/Latinx and non-Hispanic White women. However, our review emphasizes the heterogeneity of outcomes experienced by Hispanic/Latinx women. The epidemiologic advantage among Hispanic/Latinx women and their infants may be largely concentrated among specific national origin subgroups or among recently arrived foreign-born Hispanic/Latinx women. Given the disparities that exist among Hispanic/Latinx women, we provide a summary of themes to explore in future research and methodologic recommendations that may assist in identifying important subgroup differences and their determinants.

Keywords: Ethnicity; Hispanic; Immigrant paradox; Infant mortality; Low birthweight; Preterm birth.