Perinatal & Pediatric
Birth outcomes among infants born to Middle Eastern and North African immigrant women in California: a retrospective cohort 2007-2020 Laila Hamzai* Laila Hamzai Rebecca J Baer Gretchen Bandoli
Background: Although inequities in infant health outcomes by race and ethnicity have been documented, very little research is available about the Middle Eastern and North African (MENA) population in the United States (US). It is challenging to identify MENA people in datasets as they are often collapsed into the ‘non-Hispanic White’ category, which stems from their lack of representation within the US Census system. The objective of this study was to disaggregate infants born to MENA individuals from the non-Hispanic White group to determine how their birth outcomes may differ.
Methods: Using a retrospective birth cohort in California with linked health records for mother-child pairs for one year before and after delivery between 2007-2020, we identified infants born to MENA birthing individuals by using country of birth data. The study sample was limited to infants of MENA-born and US-born (non-MENA) non-Hispanic White individuals. Age adjusted log-linear regression models were used to assess perinatal outcomes among the MENA group compared to the non-MENA group.
Findings: Of >6.9 million births, 66,194 were to MENA individuals and 1,371,184 were to non-MENA individuals. Infants from the MENA group had increased risk for being small for gestational age (aRR 1.5, 95%CI 1.4, 1.5) and reduced risk for preterm birth (aRR 0.8, 95%CI 0.8, 0.9), NICU admission (aRR 0.8, 95%CI 0.8, 0.8), and infant death (aRR 0.7, 95%CI 0.6, 0.8) compared to the non-MENA group. Within the MENA group, infants of those who preferred English were less likely to have a hospital readmission (aRR 0.9, 95%CI 0.8, 0.9) and emergency room visit (aRR 0.8, 95% CI 0.7, 0.8) within one year of birth compared to those who reported another preferred language.
Conclusions: The outcomes of infants born to MENA individuals differ from the White group with which they have historically been collapsed, which supports and highlights the need for the upcoming addition of a MENA category to the 2030 Census.
