Does Preconception Health Differ by Nativity? Findings from the Los Angeles Mommy and Baby (LAMB) Study

Objectives To compare certain preconception health (PCH) behaviors and conditions among US-born (USB) and foreign-born (FB) mothers in Los Angeles County (LAC), regardless of race/ethnicity, and to determine if any identified differences vary among Asian/Pacific Islanders (API’s) and Hispanics. Methods Data are from the 2012 Los Angeles Mommy and Baby study (n = 6252). PCH behaviors included tobacco use, multivitamin use, unintended pregnancy, and contraception use. PCH conditions comprised being overweight/obese, diabetes, asthma, hypertension, gum disease, and anemia. The relationship between nativity and each PCH behavior/condition was assessed using multivariable logistic regression models. Results USB women were more likely than FB women to smoke (AOR 2.12, 95 % CI 1.49–3.00), be overweight/obese (AOR 1.57, 95 % CI 1.30–1.90), and have asthma (AOR 2.04, 95 % CI 1.35–3.09) prior to pregnancy. They were less likely than FB women to use contraception before pregnancy (AOR 0.59, 95 % CI 0.49–0.72). USB Hispanics and API’s were more likely than their FB counterparts to be overweight/obese (AOR 1.57, 95 % CI 1.23–2.01 and AOR 2.37, 95 % CI 1.58–3.56, respectively) and less likely to use contraception (AOR 0.58, 95 % CI 0.45–0.74 and AOR 0.46, 95 % CI 0.30–0.71, respectively). USB Hispanic mothers were more likely than their FB counterparts to smoke (AOR 2.47, 95 % CI 1.46–4.17), not take multivitamins (AOR 1.30, 95 % CI 1.02–1.66), and have asthma (AOR 2.35, 95 % CI 1.32–4.21) before pregnancy. Conclusions US nativity is linked to negative PCH among LAC women, with many of these associations persisting among Hispanics and API’s. As PCH profoundly impacts maternal and child health across the lifecourse, culturally-appropriate interventions that maintain positive behaviors among FB reproductive-aged women and encourage positive behaviors among USB women should be pursued.