Mexican-Americans' use of prenatal care and its relationship to maternal risk factors and pregnancy outcome.
We evaluate the adequacy of prenatal care use and the association of use to a series of maternal risk factors and pregnancy outcomes, such as low birthweight, preterm delivery, and macrosomia in both Mexican-Americans and non-Hispanic whites in Arizona. The data came from all live-birth certificates from 1986 and 1987 for a total of 101,202 (26,826 Mexican-Americans). We evaluated the adequacy of prenatal care using a redesigned index that accounts for three factors: the month when prenatal care began, the number of prenatal care visits, and the duration of pregnancy. From this index we identified six prenatal care groups: intensive, adequate, intermediate, inadequate, no-care, and missing/unknown. Overall, we observed ethnic differences in patterns of prenatal care use, social profiles, and medical risk factors. Non-Hispanic whites, compared to Mexican-Americans, showed a greater risk for low birthweight and preterm delivery in those groups receiving poor prenatal care versus those who received adequate care. Within Mexican-Americans the risk of low birthweight was not the same for all subgroups. A higher overall prevalence of preterm delivery and macrosomia in comparison to low birthweight occurred in Mexican-Americans. We discuss the implications of the results for the identification, interpretation, evaluation, and public health significance of perinatal health problems of Mexican-Americans.
Balcazar
H
H
Department of Family Resources and Human Development, Arizona State University, Tempe 85287-2502.
Cole
G
G
Hartner
J
J
D000293:Adolescent; D000328:Adult; D001130:Arizona / Q000453:epidemiology; D003625:Data Collection; D004522:Educational Status; D005260:Female; D005320:Fetal Macrosomia / Q000208:ethnology; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008423:Maternal Age; D017058:Mexican Americans / Q000706:statistics & numerical data*; D009035:Mothers / Q000523:psychology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012307:Risk Factors