Differences in Resilience among Hispanic Women and Associations with Low Birth Weight: Beyond the Hispanic Paradox


Montoya-Williams, Diana; Passarella, Molly; & Lorch, Scott (2019). Differences in Resilience among Hispanic Women and Associations with Low Birth Weight: Beyond the Hispanic Paradox. Pediatric Academic Societies Meeting. Baltimore, MD.


Background: Low birth weight (LBW) rates among Hispanic women have been described as paradoxical as their rates are lower than non-Hispanic black women (despite similar socioeconomic and health care access barriers) and similar to rates among non-Hispanic white women. The etiology of this paradox may reflect the heterogeneity among Hispanic women by differing familial culture of origin, which may result in differences in socioeconomic status (SES), education, or resilience. Objective: Describe differences in resilience by culture of origin among Hispanic women and assess for a relationship between resilience and LBW in this group. Design/Methods: We constructed a retrospective cohort of 592 Hispanic women surveyed repeatedly as part of The National Longitudinal Study of Adolescent to Adult Health (Add Health). Wave 4 questions were used to create an Add-Health resilience scale via factor analysis. Differences in resilience, SES, and LBW were measured among women of different Hispanic backgrounds. Regression models explored the relationship between resilience and LBW in this sample after adjusting for education and household income. Results: Hispanic women who identified as Cuban had the highest resilience scores, with an average score of 16.3 (SD 5.5), out of a max possible score of 29 (Table 1). Their scores were significantly higher than Puerto Rican (13.0, SD 4.8) and Central/South American women’s scores (13.3, SD 4.9) (Bonferroni corrected p-values 0.001 and 0.008, respectively). In multivariate models, Cubans were 1.8x more likely to be in a higher resilience category compared to the Mexican women reference group (Table 1). Cuban women also had the highest proportion of LBW births (14.5%) compared to the other Hispanic subgroups (Table 2), though differences were not statistically different in bivariate or multivariate analyses. The odds of LBW appeared to decrease as level of resilience increased, but these findings did not reach statistical significance (Table 3). Conclusion(s): In this sample of Hispanic women, Cuban women appeared to be more resilient than similarly aged Hispanic women of Mexican, Chicano, Puerto Rican or Central/South American background. This suggests that resilience may be culturally-mediated. However, increased resilience may not necessarily be protective with respect to LBW. Further work to delineate the relationship between resilience and adverse birth outcomes must consider the variety of cultural backgrounds within Hispanic communities.

Reference Type

Conference proceeding

Book Title

Pediatric Academic Societies Meeting


Montoya-Williams, Diana
Passarella, Molly
Lorch, Scott

Year Published


City of Publication

Baltimore, MD

Reference ID