Pregnancy outcomes of U.S.-born Puerto Ricans: the role of maternal nativity status.

This study examines maternal sociodemographic characteristics, prenatal care use, and birth outcomes of U.S. resident Puerto Ricans by maternal nativity status in order to ascertain if Puerto Rican-born mothers exhibit better birth outcomes than U.S.-born Puerto Rican mothers, after controlling for maternal risk characteristics. All single live births to U.S. resident mothers indicating a Puerto Rican heritage or ethnicity on the infant's Certificate of Live Birth were selected for analysis from the 1983-1986 National Center for Health Statistics' Public Use U.S. Linked Live Birth and Infant Death File. Infants of Puerto Rican-born mothers had a significantly lower risk of low birthweight and small for gestational age infants than infants of U.S.-born Puerto Rican mothers, after controlling for available maternal risk factors. Nevertheless, infants of Puerto Rican-born mothers had a significantly higher risk of neonatal mortality, although they exhibited a significantly lower risk of postneonatal mortality. No significant maternal nativity status differences in very preterm, preterm, very low birthweight, and infant mortality were identified after controlling for the same maternal sociodemographic and prenatal care use variables. Infants of Puerto Rican-born mothers demonstrated higher birthweight-specific neonatal mortality rates but lower birthweight-specific postneonatal mortality rates for nearly every birthweight category. These findings emphasize the need for further investigation of the factors that may influence maternal nativity variations in intrauterine growth retardation, access to tertiary health care services, and postneonatal mortality.