title: Adverse birth outcomes among Mexican-Americans: are US-born women at greater risk than Mexico-born women?
abstract: OBJECTIVE
  We examined adverse birth outcomes among Mexican-Americans to determine the effect of country of maternal birth, a measure of acculturation.
  
  
  METHODS
  We conducted a retrospective cohort analysis of birth outcomes among 4800 Mexico-born and 4800 US-born Mexican-American women using Washington State birth certificate data from 1989 to 1994. Length of residence at current address was used to help refine our measure of acculturation.
  
  
  RESULTS
  US-born women had a slightly increased risk of preterm birth relative to Mexico-born women [relative risk (RR) 1.18, 95% confidence interval (CI) 1.04-1.33]. Among Mexico-born women, the risk of preterm birth increased with greater duration of current residence.
  
  
  CONCLUSIONS
  US-born Mexican-American women had a slightly increased risk of preterm birth despite having more adequate prenatal care, more education, and higher socioeconomic indicators. This may be due to acculturation factors, such as earlier pregnancy, loss of social support systems, and increased smoking or alcohol use. Reducing this risk depends on recognition among health care workers and policy-makers of the potential influence of acculturation on health in this population.
authors.affiliation: University of Washington, School of Public Health and Community Medicine, Department of Epidemiology, Seattle, USA.
authors.forename: C
authors.initials: C
authors.lastname: Crump
authors.forename: S
authors.initials: S
authors.lastname: Lipsky
authors.forename: B A
authors.initials: BA
authors.lastname: Mueller
mesh_terms: D000069:Acculturation; D000328:Adult; D000013:Congenital Abnormalities / Q000453:epidemiology*; D003431:Cross-Cultural Comparison; D005260:Female; D015438:Health Behavior; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D008423:Maternal Age; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008800:Mexico / Q000208:ethnology; D011247:Pregnancy; D012111:Residence Characteristics; D012189:Retrospective Studies; D012306:Risk; D012959:Socioeconomic Factors; D013997:Time Factors; D014861:Washington / Q000453:epidemiology