The Association between Parity and Inflammation among Mexican-American Women of Reproductive Age Varies by Acculturation Level: Results of the National Health and Nutrition Examination Survey (1999-2006).

ABSTRACT

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 United States. 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 to 39 years, in the National Health and Nutrition Examination Survey (NHANES) from 1999 through 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, high-density lipoprotein cholesterol, waist circumference, physical activity, acculturation, and a product term of parity and acculturation. Acculturation was measured on a 6-point score based on nativity status and duration of residence in the United States (0, Mexico born, U.S. resident <10 years; 1, Mexico born, U.S. resident 10-19 years; 2-Mexico born, U.S. resident ≥20 years; and 3, U.S. born), and language used at home (0, Spanish; 1, bilingual; 2, English). Scores of 0 or 1, 2 or 3, and 4 or 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 odds ratio [OR], 2.26; 95% CI, 1.07-4.80) and moderate acculturation (adjusted OR, 2.79; 95% CI, 1.16-6.73), compared with nulliparous women. CONCLUSIONS: Higher odds of elevated CRP associated with parity in immigrant Mexican-American women of reproductive age indicate the need for greater use of maternal/women's health care services for cardiometabolic risk screening and interventions.