Introduction
Parity and acculturation are linked with cardiometabolic risk. Their joint association with cardiometabolic health among Mexican-American women is less established, even though immigrant Mexican-American women have the highest fertility rate in the US. We examined the modifying role of acculturation on the association of parity with a cardiometabolic risk biomarker, C-reactive protein (CRP).
Methods
Participants (N=1,002) were women of Mexican background, ages 16–39 years, in the National Health and Nutrition Examination Survey (NHANES) 1999–2006. The association between parity and elevated CRP was examined using logistic regression adjusted for age, household food security, access to health care, Hemoglobin A1c, total cholesterol, HDL-cholesterol, waist circumference, physical activity, acculturation, and a product term of parity and acculturation. Acculturation was measured on a six-point score based on nativity status and duration of residence in the US (0-Mexico-born, US resident < 10 years, 1-Mexico-born, US resident 10–19 years, 2-Mexico-born, US resident ≥20 years, 3-US born), and language used at home (0-Spanish, 1-bilingual, 2-English). Scores 0–1, 2–3, 4–5 represented low, moderate, and high acculturation respectively.
Results
The association of parity with elevated CRP varied by acculturation level (Pinteraction = 0.10). Parity was associated with elevated CRP among women with low (adjusted OR: 2.26, 95% CI: 1.07–4.80) and moderate acculturation (adjusted OR: 2.79, 95% CI: 1.16–6.73), compared to nulliparous women.
Conclusions
Higher odds of elevated CRP associated with parity in immigrant Mexican-American women of reproductive age indicate the need for greater utilization of maternal/women’s health care services for cardiometabolic risk screening and interventions.