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Immigrant Women Show Better Birth Outcomes: Study Of New York City Births
by Sherry Boschert
February 1, 2004
SAN FRANCISCO -- Better birth outcomes among pregnant foreign-born women in New York City compared with U.S.-born women varied considerably by country of origin, with more problems in babies born to Jamaican women and fewer problems in Chinese babies, Vani R. Bettegowda said.
Despite receiving less prenatal care in the first trimester than U.S.-born women, foreign-born women had lower rates of multiple births, low-birth-weight infants, and infant mortality in a study of New York City births from 1992 to 2001, she reported at the annual meeting of the American Public Health Association.
Strong social and familial networks among immigrants may play a beneficial role in birth outcomes; however, further research is needed between U.S.-born and foreign-born women, according to Ms. Bettegowda of New York City's Department of Health and Mental Hygiene.
Previous reports of better birth outcomes for foreign-born women prompted the current study, which took a closer look at demographic characteristics. "It is important to examine the differences by country of origin in addition to foreign-born status," she said. This may provide clues to behavioral, cultural, or psychosocial factors that could contribute to better birth outcomes.
More than half of the approximately 124,000 live births in New York City in 2001 were to foreign-born women, twice the rate seen in the United States as a whole. Although women from the Dominican Republic, Puerto Rico, and Jamaica accounted for a third of immigrant births in the city in 1992, by 2001 the largest proportions of immigrant births were to women from the Dominican Re public, Mexico, and China, accounting for nearly a third of live births.
Foreign-born mothers were more likely to receive Medicaid, which can be viewed as a proxy for poverty. U.S.-born mothers were more likely to have private insurance coverage. Immigrant women were less likely to get first-trimester prenatal care.
Infant mortality in 1992 was 8 per 1,000 live births among immigrant women and 11 per 1,000 live births among U.S.-born women. Although infant mortality decreased in both groups from 1992 to 2001, at all time points infant mortality remained significantly higher among U.S.-born women. Overall, infant mortality was 5 per 1,000 among immigrant women and 6 per 1,000 among U.S.-born women.
Causes of death related to prematurity or congenital anomalies accounted for nearly half the infant mortality in both groups. Rates of infant deaths from two potentially preventable causes--injuries and sudden infant death syndrome--were 80% lower among immigrant women.
Jamaican immigrants had higher infant mortality compared with the citywide average. Jamaican infants were more likely to have low or very low birth weight compared with infants of U.S.-born mothers. Infant mortality was lower, however, among immigrants from China, the Dominican Republic, Mexico, and Ecuador, compared with the citywide average. Infants born to women from these countries were less likely to have low or very low birth weights, compared with infants of U.S.-born mothers.
The rate of infant deaths related to pre-maturity among Jamaican women was twice as high as among infants of U.S.-born women and four times as high as in infants of women from Mexico or China. There was no difference in marital status between immigrant and U.S.-born groups.