Variations in adverse pregnancy and birth outcomes among Latin American and Caribbean-Born birthing people by region of origin, California birth cohort, 2007–2020

Table 5 Analysis of mediating influence on GDM, preterm births, and SGA outcomes among people of LAC

Region	Mediator	Outcome	Direct Effect¹	Indirect Effect²	Proportion Mediated, %³
Mexico	Prenatal Care	GDM	1.59 (1.58–1.61)	0.99 (0.99-1.0)	1.6
	^#Education	GDM	1.38 (1.37–1.39)	1.09 (1.08–1.09)	23.5
	Health Insurance	GDM	1.55 (1.53–1.56)	1.02 (1.01–1.02)	4.8
Central America	^#Prenatal Care	GDM	1.30 (1.28–1.32)	0.99 (0.99–0.99)	0.00
	^#Education	GDM	1.17 (1.15–1.19)	1.03 (1.02–1.05)	18.80
	^#Health Insurance	GDM	1.33 (1.31–1.36)	0.94 (0.93–0.96)	29.9
	Prenatal Care	SGA	1.16 (1.14–1.18)	1.00 (1.00–1.00)	0.23
	^#Education	SGA	1.17 (1.14–1.19)	0.99 (0.98–1.01)	3.17
	^#Health Insurance	SGA	1.11 (1.14–1.22)	1.05 (1.03–1.07)	33.70
Caribbean	Prenatal Care	Preterm Birth	1.15 (1.06–1.25)	1.00 (1.00–1.00)	1.60
	^#Education	Preterm Birth	1.11 (1.02–1.21)	0.99 (0.99-1.00)	0.00
	Health Insurance	Preterm Birth	1.13 (1.04–1.22)	1.03 (1.02–1.03)	19.40
	Prenatal Care	SGA	1.24 (1.15–1.34)	1.00 (0.99-1.00)	0.00
	^#Education	SGA	1.23 (1.14–1.33)	1.00 (0.99-1.00)	0.16
	Health Insurance	SGA	1.23 (1.15–1.32)	1.02 (1.02–1.02)	9.80

Footnotes:
Models adjusted for maternal age and infant year of birth
¹Effects of region on adverse pregnancy outcomes that are not mediated by each social determinant of health
²Effects of region on adverse pregnancy outcomes mediated by each social determinant of health
³Proportion of effect of region on adverse pregnancy outcomes mediated by each social determinant of health
^#Modeled with interaction term between exposure and mediator

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