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Review
. 2022 Dec;46(8):151658.
doi: 10.1016/j.semperi.2022.151658. Epub 2022 Aug 27.

Nativity and perinatal outcome disparities in the United States: Beyond the immigrant paradox

Diana Montoya-Williams  1 , Alejandra Barreto  2 , Elena Fuentes-Afflick  3 , James W Collins Jr  4
Affiliations
Review

Nativity and perinatal outcome disparities in the United States: Beyond the immigrant paradox

Diana Montoya-Williams et al. Semin Perinatol. 2022 Dec.

Abstract

In the United States (US), epidemiologists have long documented paradoxically lower rates of adverse perinatal health outcomes among immigrant birthing people than what might be expected in light of socioeconomic and language barriers to healthcare, especially as compared to their US-born racial and ethnic counterparts. However, researchers have also documented significant variability in this immigrant birth paradox when examining within and across racial and ethnic subgroups. This review paper summarizes fifty years of research regarding differences in low, preterm birth, and infant mortality in the US, according to the nativity status of the birthing person. While there is ample evidence of the importance of nativity in delineating a pregnant person's risk of adverse infant outcomes, this review also highlights the relative paucity of research exploring the intersection of acculturation, ethnic enclaves, and structural segregation. We also provide recommendations for advancing the study of perinatal outcomes among immigrants.

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Conflict of interest statement

Disclosures The authors report no proprietary or commercial interest in any concept discussed in this article. Dr. Montoya-Williams’ time is supported by NICHD K23HD102526.

Figures

Fig. 1–
Fig. 1–
Nuances of the immigrant birth outcomes paradox which merit further research exploration.
See this image and copyright information in PMC

References

    1. Mathews TJ, Driscoll AK. Trends in infant mortality in the United States, 2005–2014. NCHS Data Brief. March 2017. Published online https://www.cdc.gov/nchs/data/databriefs/db279.pdf. - PubMed
    1. Braveman P, Dominguez TP, Burke W, et al. Explaining the black-white disparity in preterm birth: a consensus statement from a multi-disciplinary scientific work group convened by the march of dimes. F Reprod Health. 2021;3. 10.3389/frph.2021.684207. - DOI - PMC - PubMed
    1. Burris HH, Hacker MR. Birth outcome racial disparities: a result of intersecting social and environmental factors. Semin Perinatol. 2017;41(6):360–366. - PMC - PubMed
    1. Chambers BD, Baer RJ, McLemore MR, Jelliffe-Pawlowski LL. Using index of concentration at the extremes as indicators of structural racism to evaluate the association with preterm birth and infant mortality-California, 2011-2012. J Urban Health. 2019;96(2):159–170. - PMC - PubMed
    1. Ayalew B, Dawson-Hahn E, Cholera R, et al. The health of children in immigrant families: key drivers and research gaps through an equity lens. Acad Pediatr. 2021;21(5):777–792. - PubMed

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