Differences in pregnancy risks and outcomes among immigrant groups to the US

Since the number of people of Hispanic and Asian origins has been increasing in the United States, it is important for healthcare workers to assess the risk factors associated with pregnancy outcomes in these ethnic groups. A study in the March issue of The Journal of Pediatrics evaluates the genetic, biologic, and social factors that may affect the fetal growth of babies born to U.S. and foreign-born Mexican and Asian-Indian mothers.

Dr. Ashima Madan and colleagues from Stanford University School of Medicine assessed 6.4 million birth records for babies born between 1995 and 2000 to compare the risks and outcomes of children born to women in the following ethnic groups: foreign and U.S.-born Asian-Indian, foreign and U.S.-born Mexican, and U.S.-born white. Demographic information, such as mother's age, education, when prenatal care was started, and heath-related characteristics, such as tobacco and alcohol use during pregnancy, complications during birth, were compared between the foreign and U.S.-born Asian Indian and Mexican women.

Foreign-born Asian-Indian women have a low-risk socio-demographic profile, such as higher rates of a college education and completion of high school, low-risk of teen pregnancy and substance abuse, although they have a higher rate of low birth weight and small for gestational age babies (infants that are smaller in size than they should be for a given stage of pregnancy). Foreign-born Mexican women, however, have a high-risk socio-demographic profile, such as lower incidence of completing high school, high-risk of teen pregnancy, less access to early prenatal care, but a lesser risk for low birth weight babies.

On the other hand, first generation U.S.-born Asian-Indian and Mexican women showed an increase in early prenatal care but also an increase in tobacco and alcohol exposure. The lower risk for low birth weight babies born to foreign-born Mexican mothers did not get passed on to the U.S.-born Mexican women. U.S.-born Asian-Indian women continued to have a higher incidence of low birth weight and small for gestational age babies.

Cross cultural research is important because, as examined in this study, having a low-risk socio-demographic profile does not necessarily mean that the pregnancy is low-risk. Dr. Ashima Madan stated that "meeting the health care needs of a diverse population can be challenging, and further research is necessary to enhance our knowledge in the area of fetal well-being."

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The study is reported in "Sociocultural factors that affect pregnancy outcomes in two dissimilar immigrant groups in the United States" by Ashima Madan, MD, Latha Palaniappan, MD, Guido Urizar, PhD, Yun Wang, MS, Stephen P. Fortmann, MD, and Jeffrey B. Gould, MD. The article appears in The Journal of Pediatrics, Volume 148, Number 3 (March 2006), published by Elsevier.


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