Pregnancy Outcomes and Documentation Status Among Latina Women: A Systematic Review

Abstract

The impression that Latinas experience paradoxically good pregnancy outcomes in the United States persists, despite evidence showing that these outcomes are not enjoyed by all Latina subgroups. We conducted this systematic literature review to examine the relationship between documentation status and pregnancy outcomes among Latinas. Methods: This review synthesizes empirical evidence on this relationship; examines how these studies define and operationalize documentation status; and makes recommendations of how a more comprehensive methodological approach can guide public health research on the impact of documentation status on Latina immigrants to the United States. We searched the literature within PubMed, Web of Science, Academic Search Premier, and Google Scholar in 2017 for relevant studies. Results: Based on stringent inclusion criteria, we retained nine studies for analysis. Conclusion: We found that evidence for the impact of documentation status on pregnancy outcomes among Latinas is not conclusive. We believe the divergence in our findings is, in part, due to variation in: conceptualization of how documentation status impacts pregnancy outcomes, sample populations, definitions of exposures and outcomes, and contextual factors included in models. Specific analytic challenges around sampling, measurement, and data analysis are identified. Suggestions for future research are offered regarding measurement of documentation status. Findings highlight the need for increased attention to documentation as an influence on Latina pregnancy outcomes.

Factors Associated With Postpartum Uninsurance Among Medicaid-Paid Births

“…There is an urgent need to address coverage gaps for all pregnant people in the US, particularly as research has found higher rates of pregnancy complications and postpartum depression among undocumented people. 22 …”

“…There is an urgent need to address coverage gaps for all pregnant people in the US, particularly as research has found higher rates of pregnancy complications and postpartum depression among undocumented people. 22 Indigenous people, particularly Indigenous rural residents, are at increased risk for severe maternal morbidity and mortality and may face unique barriers to care. 23,24 For example, relationships created by US treaty obligations may enable enrolled tribal members to access health care via the IHS, but do not always provide health insurance coverage for other health care clinicians or facilities.…”

Elevated cardiovascular disease risk in low-income women with a history of pregnancy loss

“…These findings could be another expression of so-called Latina paradox. This paradox is examined in a systematic review 24 of a large number of studies showing that, despite lower economic status, less access to medical care, Latina’s appear to have fewer complications and better pregnancy outcomes compared with other minority groups. This paradox is not well understood.…”

“…But nation of birth and documentation status may play a significant role. 24 Unfortunately, the data set used for our analysis does not allow us to shed any additional light on these questions.…”

The Health of Hispanic Children from Birth to Emerging Adulthood

“…Studies of the associations between immigrant legal status and health and development are limited because few studies directly measure legal status; most studies rely on imperfect proxy measures of unauthorized immigrant status (Richardson et al 2020). Existing evidence suggests that, compared to documented Hispanic foreign-born and U.S.-born mothers, Hispanic unauthorized immigrant mothers have similar or lower levels of preterm birth and low birthweight but higher levels of delivery complications and postpartum depression (Richardson et al 2020). Access to public benefits programs promotes health, but many immigrant families are ineligible.…”