Hispanic Pregnancy Outcomes: Differentials Over Time and Current Risk Factor Effects

Abstract

In light of major changes over the past decade or two in the structure of infant mortality in the United States, the primary objectives of this article are to document recent variation in pregnancy outcomes in specific Hispanic populations compared with non‐Hispanic Whites and to estimate the contemporaneous association of ethnicity with risk of preterm birth, low birth weight, and infant mortality. The primary data employed are the 1995–1997 NCHS Linked Birth/Infant Death Files. Changes over time are examined through comparisons with the 1989–1991 counterpart files. Logistic regression models provide estimates of ethnic disparities in birth weight, gestational age, and infant mortality. Every ethnic population followed the national pattern of increasing rates of adverse birth outcomes coupled with declining rates of infant mortality. Net of the effects of a wide range of risk factors, every Hispanic group was at greater risk of short gestation and low‐weight births, but at lower risk of infant death. The findings are consistent with the view that Hispanics, as well as the White, non‐Hispanic majority, have benefited from advances in neonatal health services and technology at the time of delivery and postpartum. The epidemiologic paradox appears to be applicable to some, but not all, Hispanic groups.