Early-Life Nutritional Ecologies and Perinatal Outcomes among Immigrants
Abstract
Research on migrant perinatal health has primarily focused on immigrants’ protection against low birth weight, often overlooking their elevated risk of fetal macrosomia. We propose a multi-sited, life-course framework linking early-life nutritional environments in mothers’ countries of origin to perinatal outcomes after migration. Using unconditional quantile regressions on Spanish birth registry microdata (2016–2021) linked to historical FAO nutritional series, we document a monotonically increasing immigrant birth-weight differential across quantiles: immigrant status is associated with protection at the lower tail of the birthweight distribution but progressively higher birth weight toward the upper tail. Adjusting for early-life nutritional environments in the origin country, proxied by the share of calories from fat, substantially attenuates this differential, reducing the immigrant coefficient by about half at the 95th percentile and explaining most of the observed attenuation. By contrast, alternative indicators of origin-country conditions—including caloric availability, protein share, GDP per capita, HDI, and infant mortality—are associated primarily with the lower tail of the distribution and provide little explanation for upper-tail differences. Additional analyses show that the upper-tail birth-weight differential is largest among immigrants whose mothers grew up in nutritional environments characterized by lower fat availability. This directional pattern is consistent with a nutritional mismatch mechanism, whereby women exposed to earlier stages of the nutrition transition encounter substantially more energy-dense nutritional environments after migration, increasing the likelihood of fetal overgrowth.
Key messages: • Migrant perinatal health should be assessed beyond low birth weight, as fetal overgrowth may be an overlooked risk.
• Early-life nutritional environments before migration may shape macrosomia risk after migration.
Related
- Maternal Selenium and Iodine Nutritional Status and Perinatal Outcomes: A Scoping Review
- Early life exposures of enteric pathogens and nutritional outcomes in Timor-Leste: a longitudinal birth cohort study protocol
- Early-life parental income mobility and risk of depression and anxiety in adolescence and young adulthood among non-immigrants and second-generation immigrants
- Substance use outcomes in first- and second- generation of immigrants: Systematic review and meta-analysis
- Effect of a Comprehensive Perinatal Education Program on Maternal Outcomes in Primigravida Mothers
BibTeX
@article{boado2026earlylife,
title = {{Early-Life Nutritional Ecologies and Perinatal Outcomes among Immigrants}},
author = {H Cebolla Boado and A Suárez Vergne and MB Lund},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1753},
url = {https://doi.org/10.1093/eurpub/ckag169.1753},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Early-Life Nutritional Ecologies and Perinatal Outcomes among Immigrants
AU - H Cebolla Boado
AU - A Suárez Vergne
AU - MB Lund
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1753
UR - https://doi.org/10.1093/eurpub/ckag169.1753
AB - Research on migrant perinatal health has primarily focused on immigrants’ protection against low birth weight, often overlooking their elevated risk of fetal macrosomia. We propose a multi-sited, life-course framework linking early-life nutritional environments in mothers’ countries of origin to perinatal outcomes after migration. Using unconditional quantile regressions on Spanish birth registry microdata (2016–2021) linked to historical FAO nutritional series, we document a monotonically increasing immigrant birth-weight differential across quantiles: immigrant status is associated with protection at the lower tail of the birthweight distribution but progressively higher birth weight toward the upper tail. Adjusting for early-life nutritional environments in the origin country, proxied by the share of calories from fat, substantially attenuates this differential, reducing the immigrant coefficient by about half at the 95th percentile and explaining most of the observed attenuation. By contrast, alternative indicators of origin-country conditions—including caloric availability, protein share, GDP per capita, HDI, and infant mortality—are associated primarily with the lower tail of the distribution and provide little explanation for upper-tail differences. Additional analyses show that the upper-tail birth-weight differential is largest among immigrants whose mothers grew up in nutritional environments characterized by lower fat availability. This directional pattern is consistent with a nutritional mismatch mechanism, whereby women exposed to earlier stages of the nutrition transition encounter substantially more energy-dense nutritional environments after migration, increasing the likelihood of fetal overgrowth. Key messages: • Migrant perinatal health should be assessed beyond low birth weight, as fetal overgrowth may be an overlooked risk. • Early-life nutritional environments before migration may shape macrosomia risk after migration.
SN - 1101-1262
SN - 1464-360X
ER -