We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Adverse Pregnancy and Neonatal Outcomes Among Marshallese Women Living in the United States.
- Authors
Nembhard, Wendy N.; Ayers, Britni L.; Collins, R. Thomas; Shan, Xiaoyi; Rabie, Nader Z.; Chang, Di; Robbins, James M.; McElfish, Pearl A.
- Abstract
Objective Despite heterogeneity among Pacific Islanders, most studies aggregate them regardless of origin. Thus, limited information is available about perinatal outcomes among various subgroups of Pacific Islanders in the United States, including immigrants from the Republic of the Marshall Islands. We sought to evaluate perinatal outcomes among Marshallese women. Methods We conducted a cross-sectional study of women with at least one singleton live birth between 1997 and 2013 in two Arkansas counties using birth certificate data from the Arkansas Department of Health. Unadjusted and adjusted prevalence ratios (PR) and 95% confidence intervals (CI) were calculated from modified Poisson regression models. Results Of the 91,662 singleton births in both counties during the study period, 2488 were to Marshallese women. In adjusted analyses, Marshallese women had higher prevalence of "other medical risk factors" (PR = 1.47; 95% CI 1.30, 1.65) than NH White women. Marshallese women had higher rates of precipitous labor and fetal distress during labor compared to NH White women (PR = 2.65; 95% CI 2.22, 3.17 and 1.89; 95% CI 1.62, 2.21, respectively). Marshallese were also more likely to have tocolysis (PR = 1.43; 95% CI 1.16, 1.76), forceps (PR = 1.68; 95% CI 1.16, 2.43) or vacuum (PR = 1.89; 95% CI 1.60, 2.22) used in delivery and cesarean section (PR = 1.13; 95% CI 1.01, 1.27). Marshallese infants had higher rates of anemia (PR = 3.10; 95% CI 2.01, 4.77), birth injury (PR = 2.13; 95% CI 1.50, 3.03), assisted ventilation < 30 min (PR = 2.11; 95% CI 1.64, 2.71), preterm birth (PR = 1.67; 95% CI 1.50, 1.83), and small-for-gestational age (PR = 1.25; 95% CI 1.12, 1.39) than NH White infants. Conclusions Marshallese women and infants had higher rates of adverse perinatal outcomes compared to their NH White counterparts. Additional studies are needed to determine if perinatal outcomes among the Marshallese differed from other Pacific Islander subgroups.
- Subjects
OCEANIA; ARKANSAS; PREGNANCY complication risk factors; LABOR complications (Obstetrics) -- Risk factors; ANALYSIS of variance; ARTIFICIAL respiration; ASIANS; BIRTH injuries; BIRTH size; CESAREAN section; CHI-squared test; CONFIDENCE intervals; FETAL distress; PSYCHOLOGY of immigrants; PREMATURE infants; LABOR complications (Obstetrics); EVALUATION of medical care; OBSTETRICAL extraction; POISSON distribution; PREGNANCY; PREGNANCY complications; PRENATAL care; RESEARCH funding; WOMEN'S health; MULTIPLE regression analysis; PSYCHOSOCIAL factors; CROSS-sectional method; DESCRIPTIVE statistics; EVALUATION
- Publication
Maternal & Child Health Journal, 2019, Vol 23, Issue 11, p1525
- ISSN
1092-7875
- Publication type
Article
- DOI
10.1007/s10995-019-02775-8