Should Hispanic persons from different countries of origin be combined into one sample for analysis?

Pregnancy Outcomes among Hispanics Stratified by Country of Origin

OBJECTIVE

This study aimed to compare the perinatal outcomes among U.S.-born and foreign-born Hispanics and Caucasians and ascertain if length of time in the US was associated with the rate of adverse outcomes.

STUDY DESIGN

Retrospective cohort analysis of gravidae enrolled in our institutional perinatal database. Women delivering a non-anomalous, singleton, at 24 weeks or more and self-identified as Caucasian or Hispanic were included. Women were stratified by country of birth and ethnicity into U.S.-born Caucasian, U.S.-born Hispanic, and U.S. foreign-born Hispanic. Composite maternal (CMM) and neonatal (CNM) morbidity was assessed.

RESULTS

Of 20,422 women, 21% were Caucasian, 15% were U.S.-born Hispanics, and 64% were U.S. foreign-born Hispanics. Compared to Caucasians, U.S.-born and foreign-born Hispanic were older, more likely to be a grand multiparous, obese and less likely to be married. Compared to Caucasians, foreign-born Hispanics had a 1.42-fold increased risk of CMM (95% CI 1.26-1.30). Paradoxically, the rate of CNM was 40% lower among neonates born to foreign-born Hispanics (95% CI 0.51-0.74). A significant direct relationship was noted between time in the USA and CMM but not CNM among foreign-born Hispanics.

CONCLUSION

Despite less favorable baseline characteristics, U.S. foreign-born Hispanics have 40% less CNM compared to both Caucasians and U.S.-born Hispanics.