Children Of Foreign-born Mothers Research Articles

Childhood Overweight/Obesity amidst Migration, Socioeconomic Factors, and Obesogenic Behaviors: Insights from the Growing Up in New Zealand Study

Research on migration as a risk factor for obesity has produced inconsistent findings. Potential influence of migration as a social determinant of obesity has not been previously explored in New Zealand (NZ) as a migrant receiving country. This study aimed to investigate the link between maternal migration status and residential duration and childhood overweight/obesity risk in NZ, considering sociodemographic characteristics and obesogenic behaviors. Data on 5,506 4- to 5-year-old children and their mothers were taken from a large and nationally representative cohort study in NZ (the Growing Up in NZ Study). Multivariable logistic regression analyses were conducted to examine the association between maternal migration status, maternal residential duration, and child’s overweight/obesity risk and the risk of adopting obesogenic behaviors independent of socioeconomic influences. A lower proportion of children of foreign-born mothers presented with overweight/obesity (26%) at age 5 years compared with children of NZ-born mothers (29.6%) (adjusted odds ratio (AOR) 0.85, 95% confidence interval (CI) (0.74, 0.98)). Maternal residential duration had no association with children’s weight status among migrant families. Regarding obesogenic behaviors, the findings were mixed with children of foreign-born mothers having lower odds of consuming fast food (AOR 0.77, 95% CI (0.65, 0.91)) and soft drinks (AOR 0.87, 95% CI (0.76, 0.99)); however, they had higher odds of having inadequate sleep duration (AOR 2.25, 95% CI (1.85, 2.73)). The lower prevalence of overweight/obesity and lower odds of consuming fast foods and soft drinks among children of foreign-born mothers indicate potential protective factors within migrant families. However, the increased likelihood of inadequate sleep duration highlights an area of concern that warrants further attention and intervention. The findings emphasize the importance of considering diverse social determinants of health and specific risk factors when developing targeted interventions to address childhood overweight/obesity.

Acculturation and 4-year caries increment among children of foreign-born mothers in Sweden: a register-based cohort study

BackgroundTo study the association of maternal age upon arrival and length of residence in Sweden with the 4-year caries increment in their children between ages 3 and 7 years in relation to the human development index (HDI) of the maternal country of origin.MethodThis registry-based cohort study included all children born in 2000–2003 who resided in Stockholm County, Sweden, at age 3 years and who were followed up at age 7 (n = 63,931). Negative binomial regressions were used to analyze different models adjusted for sociodemographic factors.ResultsChildren of foreign-born mothers, regardless of the HDI of the maternal country of origin, had a higher risk of caries increment between ages 3 and 7 years than children of Swedish-born mothers. Furthermore, children of mothers who had arrived from a low or medium HDI country had a lower caries increment if their mothers arrived before age 7 compared with after age 7. Nearly half (44%) of the children whose mothers arrived in Sweden at age ≥ 20 years from a low HDI country had a caries increment compared to 22% of the children whose mothers had arrived in Sweden before 7 years of age. Furthermore, children whose mothers were born in a low HDI country and had resided in Sweden ≤ 19 years had approximately 1.5 times higher risk of caries increment compared to children of mothers who had resided in Sweden for more than 20 years.ConclusionsCaries increment in the children of foreign-born mothers was associated with the age of their mother when she arrived in Sweden and was lower when the mother had arrived before age 7 years. This indicates an intergenerational effect that carries over to the children and is greater the longer the mother has participated in Swedish dental healthcare.

Inequalities in Exposure to Ambient Air Neurotoxicants and Disparities in Markers of Neurodevelopment in Children by Maternal Nativity Status.

Exposure levels to environmental pollutants vary significantly among different populations. These inequities in exposure to hazardous air pollutants (HAP) among different populations can contribute to disparities in neurodevelopmental outcomes. The aim of this study was to determine if exposure to HAP varies by maternal nativity status, a demographic marker often overlooked in the study of health disparities. We also assessed if those inequalities in exposure levels are associated with neurodevelopmental measures in young children. To do this, we obtained data from the Early Childhood Longitudinal Study-Birth cohort (ECLS-B), a nationally representative sample of children born in the U.S. in the year 2001 (n = 4750). Bayley’s Short Form-Research Edition (BSF-R) was used to measure cognitive development at 2 years of age. Using residential location at nine months of age, participants were assigned exposures to ten HAPs identified as potentially neurotoxic. Linear regression models were used to assess the joint effect of maternal nativity status and HAP exposure on neurodevelopment. Results showed inequities in exposure levels to ten different HAPs among the populations, as approximately 32% of children of foreign-born mothers were exposed to high levels of HAPs, compared to 21% of children born to U.S.-born mothers. Adjusting for socioeconomic factors, both isophorone exposure (a marker of industrial pollution) (−0.04, 95% CI, −0.12, 0.04) and maternal nativity status (−0.17, 95% CI, −0.27, −0.06) were independently associated with lower standardized BSF-R mental scores in children. Interaction between nativity status and isophorone was not statistically significant, but the change in mental scores associated with isophorone exposure was greater in children of foreign-born mothers compared to children of U.S.-born mothers (−0.12, vs. −0.03, p = 0.2). In conclusion, exposure to HAPs within the highest quartile was more commonly found among children of foreign-born mothers as compared to children of US-born mothers, indicating inequities in pollutant exposure by nativity status within urban populations. Exposures associated with nativity status may negatively contribute to children’s neurodevelopment.

Association of Maternal Nativity Status and Race/Ethnicity on Emergency Department Utilization Among Children in Vulnerable Families.

We aimed to determine the role of mothers' nativity and race/ethnicity on their children's emergency department utilization. Data from the Fragile Families and Child Wellbeing Study was used for the analyses. Descriptive and regression analyses were conducted to compare use of ED services between children of foreign-born versus US-born mothers within different racial groups. The sample in this analysis contained 3426 mother-child pairs, of which 14.2% were foreign-born mothers. Adjusting for mother's race, education, and marital status, child's insurance coverage, and caregiver's perception of child's health, children of foreign-born mothers were less likely to use ED services compared with those born to US-born mothers (risk ratio [RR], 0.71 [0.54-0.94]). Emergency department utilization was lower among children of Hispanic, foreign-born mothers (RR, 0.67 [0.46-0.96]) and among children of non-Hispanic Asian or other race, foreign-born mothers (RR, 0.32 [0.14-0.74]) when compared with children of their US-born counterparts in the respective race. Maternal nativity status and race influence child's use of emergency department services. Future research should explore the intersection of parental nativity, immigrant documentation status, and citizenship status and how that may influence children's health care usage.

Association of maternal ethnicity and urbanicity on severe pediatric disease: a nationwide cohort study

BackgroundA healthy migrant effect on birth outcomes has been reported, however, whether this protective effect persists throughout childhood is unknown. The effect of urbanicity on child health among an immigrant population is unclear. The objective of this study was to compare the incidence rate and cumulative incidence of severe diseases among urban children of Taiwan-born mothers, rural children of Taiwan-born mothers, urban children of foreign-born mothers, and rural children of foreign-born mothers.MethodsA nationwide cohort study was conducted for children born in Taiwan during 2004–2011 and follow-up till age 4 to 11 years old by linkage the Taiwan Birth Registry 2004–2011, Taiwan Death Registry 2004–2015, and National Health Insurance Research Database 2004–2015. Cox proportional hazards model (multivariable) was used to examine differences among the four study groups.ResultsThere were 682,982 urban children of Taiwan-born mothers, 662,818 rural children of Taiwan-born mothers, 61,570 urban children of foreign-born mothers, 87,473 rural children of foreign-born mothers. Children of foreign-born mothers had a lower incidence of vasculitis, mainly Kawasaki disease. The incidences of congenital disorders did not differ between children of foreign-born mothers and children of Taiwan-born mothers. The incidence of psychotic disorders was higher in urban children. However, children in rural areas had a higher incidence of major trauma/burn and a higher mortality rate.ConclusionsA healthy migrant effect was only seen for Kawasaki disease. The mental health of urban children born to immigrant mothers warrants concern.

Hospital admissions in children with developmental disabilities from ethnic minority backgrounds.

To compare hospital admission patterns after the first year of life in Australian children with developmental disabilities and children with no known disability, according to maternal country of birth and Indigenous status. This was a retrospective cohort study using linked data across health, disability, and hospital admission databases. The study investigated 656174 children born in Western Australia between 1983 and 2008 with a total of 1091834 records of hospital admissions. Children with no known disability born to Indigenous mothers had the highest rate of hospital admissions compared to children of non-Indigenous mothers. Children of foreign-born mothers from low-income countries had the highest rate of hospital admissions if disability was present. Children with cerebral palsy (CP) with or without associated intellectual disability had the highest rate of hospital admissions among children with developmental disability, especially if mothers were foreign-born. Children with CP and intellectual disability, particularly from minority backgrounds (Indigenous Australian and foreign-born mothers), were at higher risk of being admitted to hospital after the first year of life. Hospital admissions in Australian children with and without disabilities differ according to maternal country of birth. Hospital admission rates in children without a developmental disability were greatest for Australian-born Indigenous children. Disabled Australian-born children of foreign-born mothers from low-income countries had the highest hospital admission rates. Hospital admission risk was greatest for Australian-born children with cerebral palsy, especially if mothers were foreign-born.

Health among Black children by maternal and child nativity.

We examined 5 health outcomes among Black children born to US-born and foreign-born mothers and whether differences by mother's region of birth could be explained by maternal duration of US residence, child's place of birth, and familial sociodemographic characteristics. Data were from the 2000-2011 National Health Interview Surveys. We examined 3 groups of children, based on mother's region of birth: US origin, African origin, and Latin American or Caribbean origin. We estimated multivariate regression models. Children of foreign-born mothers were healthier across all 5 outcomes than were children of US-born mothers. Among children of foreign-born mothers, US-born children performed worse on all health outcomes than children born abroad. African-origin children had the most favorable health profile. Longer duration of US residence among foreign-born mothers was associated with poorer child health. Maternal educational attainment and other sociodemographic characteristics did little to explain these differences. Further studies are needed to understand the role of selective migration and the behavioral, cultural, socioeconomic, and contextual origins of the health advantage of Black children of foreign-born mothers.

Mortality of New York children with sickle cell disease identified through newborn screening.

Long-term follow-up of newborn screening for conditions such as sickle cell disease can be conducted using linkages to population-based data. We sought to estimate childhood sickle cell disease mortality and risk factors among a statewide birth cohort with sickle cell disease identified through newborn screening. Children with sickle cell disease identified by newborn screening and born to New York residents in 2000-2008 were matched to birth and death certificates. Mortality rates were calculated (using numbers of deaths and observed person-years at risk) and compared with mortality rates for all New York children by maternal race/ethnicity. Stratified analyses were conducted to examine associations between selected factors and mortality. Among 1,911 infants with sickle cell disease matched to birth certificates, 21 deaths were identified. All-cause mortality following diagnosis was 3.8 per 1,000 person-years in the first 2 years of life and 1.0 per 1,000 person-years at ages 2-9 years. The mortality rate was significantly lower among children of foreign-born mothers and was significantly higher among preterm infants with low birth weight. The mortality rates were not significantly higher for infants after 28 days with sickle cell disease than for all New York births, but they were 2.7-8.4 times higher for children 1 through 9 years old with homozygous sickle cell disease than for those of all non-Hispanic black or Hispanic children born to New York residents. Estimated mortality risk in children with homozygous sickle cell disease remains elevated even after adjustment for maternal race/ethnicity. These results provide evidence regarding the current burden of child mortality among children with sickle cell disease despite newborn screening.Genet Med 17 6, 452-459.

Autism spectrum disorders and race, ethnicity, and nativity: a population-based study.

Our understanding of the influence of maternal race/ethnicity and nativity and childhood autistic disorder (AD) in African Americans/blacks, Asians, and Hispanics in the United States is limited. Phenotypic differences in the presentation of childhood AD in minority groups may indicate etiologic heterogeneity or different thresholds for diagnosis. We investigated whether the risk of developing AD and AD phenotypes differed according to maternal race/ethnicity and nativity. Children born in Los Angeles County with a primary AD diagnosis at ages 3 to 5 years during 1998-2009 were identified and linked to 1995-2006 California birth certificates (7540 children with AD from a cohort of 1,626,354 births). We identified a subgroup of children with AD and a secondary diagnosis of mental retardation and investigated heterogeneity in language and behavior. We found increased risks of being diagnosed with AD overall and specifically with comorbid mental retardation in children of foreign-born mothers who were black, Central/South American, Filipino, and Vietnamese, as well as among US-born Hispanic and African American/black mothers, compared with US-born whites. Children of US African American/black and foreign-born black, foreign-born Central/South American, and US-born Hispanic mothers were at higher risk of exhibiting an AD phenotype with both severe emotional outbursts and impaired expressive language than children of US-born whites. Maternal race/ethnicity and nativity are associated with offspring's AD diagnosis and severity. Future studies need to examine factors related to nativity and migration that may play a role in the etiology as well as identification and diagnosis of AD in children.

Revisiting the Hispanic Health Paradox: The Relative Contributions of Nativity, Country of Origin, and Race/Ethnicity to Childhood Asthma

This study examined the relationship between race and Hispanic ethnicity, maternal and child nativity, country of origin and asthma among 2,558 non-Hispanic white and Hispanic children across 65 Los Angeles neighborhoods. A series of two-level multilevel models were estimated to examine the independent effects of race, ethnicity, and country of origin on childhood asthma. Lifetime asthma prevalence was reported among 9% of children, with no significant differences between Hispanics and non-Hispanic whites overall. However, in fully adjusted models, Hispanic children of non-Mexican origin reported higher odds of asthma compared to non-Hispanic white children. A protective nativity effect was also observed among children of foreign born mothers compared to US born mothers. Our study provides evidence in support of the heterogeneity of childhood asthma by Hispanic ethnicity and maternal nativity. These findings suggest moving beyond solely considering racial/ethnic classifications which could mask subgroups at increased risk of childhood asthma.

Racial and ethnic disparities: A population-based examination of risk factors for involvement with child protective services

ObjectiveData from the United States indicate pronounced and persistent racial/ethnic differences in the rates at which children are referred and substantiated as victims of child abuse and neglect. In this study, we examined the extent to which aggregate racial differences are attributable to variations in the distribution of individual and family-level risk factors. MethodsThis study was based on the full population of children born in California in 2002. Birth records were linked to child protective service (CPS) records to identify all children referred for maltreatment by age 5. Generalized linear models were used to compute crude and adjusted racial/ethnic differences in children's risk of referral, substantiation, and entry to foster care. ResultsAs expected, stark differences between Black and White children emerged in the rates of contact with CPS. Black children were more than twice as likely as White children to be referred for maltreatment, substantiated as victims, and enter foster care before age 5. Yet, there were also significant differences across racial/ethnic groups in the distribution of socioeconomic and health factors strongly correlated with child maltreatment and CPS involvement. After adjusting for these differences, low socioeconomic Black children had a lower risk of referral, substantiation, and entry to foster care than their socioeconomically similar White counterparts. Among Latinos, before adjusting for other factors, children of U.S.-born mothers were significantly more likely than White children to experience system contact, while children of foreign-born mothers were less likely to be involved with CPS. After adjusting for socioeconomic and health indicators, the relative risk of referral, substantiation, and foster care entry was significantly lower for Latino children (regardless of maternal nativity) compared to White children. ConclusionsRace and ethnicity is a marker for a complex interaction of economic, social, political, and environmental factors that influence the health of individuals and communities. This analysis indicates that adjusting for child and family-level risk factors is necessary to distinguish race-specific effects (which may reflect system, worker, or resource biases) from socioeconomic and health indicators associated with maltreatment risk. Identifying the independent effects of these factors is critical to developing effective strategies for reducing racial disparities.

Factors predicting early childhood education and care use by immigrant families

Using 2005 National Household Education Survey data, this paper compares the effects of child and family characteristics on early childhood education and care use for children of foreign born mothers versus children of native-born mothers. Maternal nativity serves as a proxy for maternal immigration status in an effort to determine if child and family characteristics differentially predict enrollment. We consider relative, non-relative, and center-based care arrangements in two age groups: 0–2 and 3–5 years old. Multivariate analyses reveal that once demographic differences are controlled, patterns of use are mostly similar irrespective of maternal nativity.

Unintentional injuries in children of Danish and foreign-born mothers

Unintentional injuries in children of foreign-born mothers were studied and compared with those in children of Danish-born mothers. A population of 173,504 children living in 32 municipalities in Denmark was followed from 1998 to 2003. Detailed information on childhood unintentional injuries from hospital records was linked to register data on parents' education, country of origin, income, family type, etc. Poisson regression was used to analyse differences in injury risk between children of different origins. We found 133,649 injuries, of which 15,389 occurred in children of foreign-born mothers. The injury rates in children of Western and non-Western origin were 0.83 (0.70-0.98) times and 0.84 (0.79- 0.90) times that of children of Danish-born mothers, respectively. The difference was largest in children of families with unemployed parents. The injury rate in girls of non-Western origin was 29% lower than in girls of Danish origin, while the rate in boys of non-Western origin was only 5% lower than in boys of Danish origin. This gender difference was particularly pronounced for sports and traffic injuries. Children of non-Western origin had a three-fold higher rate of burns caused by hot water, tea or oil than children of Danish origin. Prevention of injuries in children of non-Western origin should especially focus on scalds from tea, oil, and hot water.

Roots of assimilation

This study examines the relationship between children's generational status and their cognitive and social school readiness, paying particular attention to racial/ethnic and national origin differences. This relationship is examined using data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998—99 (ECLS-K). Results indicate that, while children of foreign-born mothers tend to have lower levels of school readiness than children of native-born mothers, this disparity is largely due to differences in family context characteristics. After controlling for an array of family background variables, non-Hispanic black, Asian, Mexican, Puerto Rican and other Hispanic children of foreign-born mothers are found to have similar levels of academic school readiness to co-ethnic children of American-born mothers. Analyses also indicate that a substantial portion of the school readiness gaps between minority children of foreign-born mothers and non-Hispanic white children of American-born mothers can be explained by family background differences. The study includes a discussion of the implications for assimilation theory and the study of early educational inequality.

Caries prevalence in 2-year-old children in the city of Zurich.

To establish caries prevalence in 2-year-olds in the city of Zurich; and to investigate the relationship between caries prevalence and dietary habits, and oral hygiene practices in native children and children with immigrant background. 1,000 randomly selected 2-year-olds were invited to participate in a clinical examination, at which parents were interviewed about the child's oral hygiene and dietary habits. Caries diagnosis was based on visual inspection of all tooth surfaces and included both initial (d1) and cavitated (d2) lesions. Univariate and multivariate logistic regressions for two subgroups of children (children of Swiss and foreign-born mothers) were performed in order to assess the association between predictor variables and caries. 771 children were examined (participation rate 78%; mean age 2.4 years (age range 2.06-2.90 years)). Although the majority (94%) was born in Switzerland, 61% of children had immigrant backgrounds (mother not born in Switzerland). Cavitated teeth (d2mft) were observed in 12.6% of children (95% CI: 10.4-15.1%). Caries including initial lesions (dl2mft) affected 25.3% of children (95% CI: 22.4-28.5%). There were 34 (4.4%) children with severe caries (all maxillary incisors cavitated). For children with caries, the mean d2mft was 4.3 (+/- 2.8). Children with foreign-born mothers (mothers not born in Switzerland) exhibited a significantly higher caries prevalence than those with Swiss-born mothers (17.4% versus 5.0% with d2mft > 0). Children with foreign-born mothers exhibited significantly higher caries prevalence rates than those with Swiss-born mothers. Poor oral hygiene and night-time bottle use were identified as risk indicators for caries in all children. Further risk indicators identified in children of foreign-born mothers were a preference for sugar-containing non-milk drinks, no pacifier use, child's age and male gender.

Early childhood caries — facts and prevention

In 2003, 771 randomly selected two-year-old children from the town of Zurich were examined. Teeth with carious cavities were observed in 12.6% of the children. Caries including initial (not yet cavitated) lesions was seen in 25.3% of children. Caries prevalence was strongly associated with immigrant background. Caries was found in 7.5% of Swiss children and in 38.5% of children from ex-Jugoslavia. 5% of children of mothers born in Switzerland, and 17.4% of children of mothers not born in Switzerland showed caries. The average number of teeth with carious lesions in children with caries was 4.3 irrespective of immigrant or Swiss background. This finding suggests that all kids with caries had similar risk behaviours. Multivariate logistic regressions elucidated the behavioural components associated with caries. The presence of plaque and the use of a night-time bottle proved to be the strongest predictor variables for caries. Frequent drinking of sugared non-milk drinks, age and no pacifier use were further risk indicators in children of foreign-born mothers. A significant improvement of oral health of small children can be achieved by a concerted action of child welfare consultants, paediatricians and carers of day-nurseries. The primary goal is to convince parents to actively participate in preserving dental health of their offsprings. The following recommendations should be adhered to: 1. Parents should brush the teeth of the children daily, using a fluoridated children-toothpaste starting the very day of the appearance of the first milk tooth. 2. At the age of 12 months, the bottle should be replaced by a cup and the continuous use of a nursing bottle while falling asleep and during the night should absolutely be avoided. 3. Children should primarily be offered water and milk as a beverage. A first dental inspection is due at the age of two years.