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Objective: To assess the relation between Latino ethnicity, Latino subgroup, and low birth weight (LBW). Data Sources: From the MEDLINE computer database, we used the key words birth weight; infant, LBW; Latinos; Hispanic Americans; Cuban Americans; Mexican Americans; and Puerto Ricans to identify studies that analyzed LBW in Latinos. Study Selection: Thirty-two studies, published from 1982 to 1996, that analyzed US Latinos and whites or multiple Latino subgroups, that used the revised definition of LBW ([is less than] 2500 g), and had a large sample size ([is greater than] 10 000) were selected. Data Extraction: Two reviewers extracted LBW rates and data on the relation between Institute of Medicine risk factors and LBW by maternal ethnicity and Latino subgroup. Date Synthesis: Low-birth-weight rates were similar for Latino (median, 6.2%) and white infants (median, 5.8%). By Latino subgroup, LBW rates were similar for Central/South American, Cuban, Mexican, and white infants. Puerto Rican infants had consistently higher LBW rates (median, 9.1%). Two risk factors-maternal birthplace and gestational weight gain-were identified as confounders of the relation between Latino ethnicity, Latino subgroup, and LBW. Conclusions: Low-birth-weight rates of Latinos and whites are similar, consistent with the 'epidemiologic paradox' of unexpectedly favorable perinatal outcomes for Latinos. However, this paradoxical relation for all Latinos masks the notably elevated LBW risk among Puerto Ricans. Further study of LBW among Latinos, including cultural factors, is needed. Arch Pediatr Adolesc Med. 1997; 151:665-674, Latino and white women have similar rates of low-birth-weight (LBW) babies, despite lower socioeconomic status and less prenatal care among Latinos. As these factors generally are associated with poorer health, this pattern has been described as an epidemiologic paradox. Researchers reviewed 32 large studies and found that Puerto Rican women have a greater rate of LBW babies. Women who retain a Mexican cultural orientation have half the rate of LBW babies as Mexican women acculturated to the US. Maternal nutrition and other cultural factors may influence birthweight differently across ethnic groups.

Background: Cancer incidence varies among race and ethnic subgroups. Relatively little information exists on cancer among Hispanics, and none of it is stratified by race. Methods: To explore and compare cancer incidence rates of each site of cancer among white Hispanic, white non-Hispanic, black Hispanic, and black non-Hispanic women in Dade County, South Florida, we accessed 9 years of cancer incidence data. Dade County's Hispanic population is the second largest of any US county. For each site, incidence rates, rate ratios, and 95% confidence intervals are presented. Results: Among white Hispanics, there were statistically significant lower rates of cancers of the oral cavity, esophagus, colon, pancreas, lung, breast, ovary, bladder, kidney, melanoma, Kaposi's sarcoma, and non-Hodgkin's lymphoma than among white non-Hispanics. Black Hispanics had significantly lower rates of cancers of the oral cavity, stomach, rectum, lung, cervix, and bladder than black non-Hispanics. However, white Hispanic women had significantly higher rates of cancers of the liver, gallbladder, and uterine cervix than white non-Hispanic women. No in situ breast cancer cases among blacks of either ethnic subgroup was found. Conclusion: Both white Hispanic and black Hispanic women generally had lower rates of cancer than their race-specific non-Hispanic counterparts. However, incidence rates among Hispanics differ substantially by race; failure to distinguish them may lead to erroneous conclusions. (Arch Intern Med. 1994;154:1083-1088)

Background: Rates of low-birth-weight (LBW) infants are similar between Latina and white women, an epidemiologic paradox. However, few studies have analyzed the relationship between ethnicity, Latino subgroup, confounding variables, and LBW. Methods: We analyzed 395 070 singleton livebirths to Latina and non-Latina white women in California during 1992. Multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the risks due to Latino ethnicity and Latino subgroup for very LBW (VLBW, 500-1499 g) and moderately LBW (MLBW, 1500-2499 g) outcomes. Results: Latina and white women had similar unadjusted rates of VLBW (0.7% vs 0.6%) and MLBW infants (3.7% vs 3.4%). After adjusting for maternal age, education, birthplace, marital status, parity, tobacco use, use of prenatal care, infant sex, and gestational age, there was no difference in the odds of VLBW infants between Latina and white women (OR, 0.93 [95% CI, 0.81-1.07]). Latina women had minimally elevated odds of MLBW infants (OR, 1.06 [95% CI, 1.01-1.11]) compared with white women. By Latino subgroup, there was no difference in the adjusted odds of VLBW infants among Central and South American, Cuban, Mexican, Puerto Rican, and white women. The adjusted odds of MLBW infants were elevated among Central and South American (OR, 1.14 [95% CI, 1.05-1.25]) and Puerto Rican women (OR, 1.41 [95% CI, 1.12-1.78]), relative to white women. Conclusions: The epidemiologic paradox of LBW in Latinos is valid. New conceptual models are needed to identify Latina women who are at risk for adverse pregnancy outcomes. Arch Pediatr Adolesc Med. 1999;153:147-153, Latina women seem to be at lower risk of having low-birthweight babies than white women, even though they are economically less advantaged. Generally, low socioeconomic class is associated with low birthweight, yet Latina women seen to defy this pattern. Researchers examined birth records of 395,000 infants born in California to identify factors contributing to this 'Latino paradox.' Latinas were younger, less educated, and received poorer prenatal care than white women, but they were less likely to smoke. No clear factors explaining the paradox were apparent, but Latinas may eat more nutritious diets and benefit from social and cultural advantages favoring healthy pregnancy and childbirth.

Background: Although immigrants to the United States are usually ethnic minorities and socioeconomically disadvantaged, foreign-born women generally have lower rates of low birth weight infants than do US-born women. Objective: To measure the relationship between maternal birthplace, ethnicity, and low birth weight infants. Design: Retrospective cohort study of birth certificate data. Setting: California, 1992. Subjects: Singleton infants (n = 497 868) born to Asian, black, Latina, and white women. Main Outcome Measures: Very low birth weight (500-1499 g), moderately low birth weight (1500-2499 g), and normal birth weight (2500-4000 g, reference category). Results: Foreign-born Latina women generally had less favorable maternal characteristics than US-born Latinas, yet foreign-born Latina women were less likely to have moderately low birth weight infants (odds ratio, 0.91; 95% confidence interval, 0.86-0.96) than US-born Latinas after adjusting for maternal age, education, marital status, parity, tobacco use, use of prenatal care, and gestational age. While foreign-born Asian women generally had a less favorable profile of maternal characteristics than US-born Asians, there was no statistically significant difference in the odds of very low birth weight or moderately low birth weight infants between foreign and US-born Asian women. Foreign-born black women had more favorable maternal characteristics than US-born women, but there was no significant nativity difference in very low birth weight or moderately low birth weight between foreign- and US-born black women after adjusting for maternal and infant factors. Conclusions: The relationship between maternal birthplace and low birth weight varies by ethnicity. Further study is needed to understand the favorable pregnancy outcomes of foreign-born Latina women. Arch Pediatr Adolesc Med. 1998;152:1105-1112, More research is needed to determine why foreign-born Hispanic women have lower rates of low birth weight than US-born Hispanic women. An analysis of the birth records of 497 868 infants born in California in 1992 found that foreign-born Hispanic women had lower rates of low birth weight than US-born Hispanic women even though they were more likely to have risk factors for low birth weight. This difference between foreign-born and US-born women was not seen in black women or Asian women.