Baseline Differences and Comparative Change in Pregnancy and Birth Outcomes for the Asian Indian American Population: Findings from the 2014-2022 National Vital Statistics System Natality Data.

PURPOSE: To analyze changes in pregnancy and birth outcomes for the rapidly growing Asian Indian American (AIA) population between 2014 and 2024, comparing foreign born to US born individuals. METHODS: Using national singleton birth certificate data, logistic and Poisson regression models tested the significance of year and nativity status for ten adverse pregnancy and birth outcomes, adjusting for pre-pregnancy sociodemographic and clinical characteristics. RESULTS: There were 57,684 births in 2014 (90.0% immigrant) and 71,398 births in 2024 (86.9% immigrant), reflecting a 23.8% increase. In 2024 the AIA population was older and more educated with a higher prevalence of pre-pregnancy hypertension, diabetes, and obesity. In adjusted analyses, there was an 85% increase in the likelihood of any hypertensive disorder of pregnancy, a 35% increase in the likelihood of gestational diabetes, and a 72% increase in the likelihood of not initiating breastfeeding. CONCLUSIONS: The AIA birthing population is affected by increasing pre-pregnancy risk factors and adverse metabolic and hypertensive conditions. By 2024, over 20% of AIA birthing individuals experienced at least one adverse pregnancy or birth outcome. These findings pose a major life course challenge to the health of pregnant individuals and their offspring that require both public health and clinical interventions.