Elevated risk factors for adverse pregnancy outcomes among Filipina-Canadian women.
OBJECTIVE
Filipina immigrant women have higher than expected rates of preeclampsia and perinatal morbidity. Since obesity, diabetes mellitus (DM), and chronic hypertension are established risk factors for adverse pregnancy outcomes, we sought to determine whether they are more prevalent among Filipina women than other East Asian and Caucasian women.


METHODS
We pooled data from the 2000-01, 2003, 2005, and 2007 cycles of the nationally administered Canadian Community Health Survey. We generated data representative of 115,842 Filipina, 394,357 other East Asian, and 5,812 851 Caucasian women aged 18 to 49 years and living in Canada. Crude and adjusted odds ratios and 95% confidence intervals expressed the association between ethnicity and the risk of overweight (BMI >or= 25.0 kg/m(2)), obesity (BMI >or= 30.0 kg/m(2)), DM, and chronic hypertension.


RESULTS
The respective rates of obesity were approximately 5% for Filipinas, 2% for other East Asian women, and 14% for Caucasian women. The adjusted OR of obesity was 0.28 (95% CI 0.16 to 0.47) among Filipina women and 0.14 (95% CI 0.10 to 0.20) among other East Asians. The risk of DM was not significantly lower in Filipina women or other East Asian women than in Caucasians. Relative to a rate of 4.8% among Caucasians, chronic hypertension was significantly more prevalent among Filipinas (7.1%; adjusted OR 2.14, 95% CI 1.51 to 3.03), but not other East Asians (3.9%; adjusted OR 1.27, 95% CI 0.96 to 1.70). Post-hoc analyses showed that Filipina women were more likely to be hypertensive (adjusted OR 1.79, 95% CI 1.12 to 2.85) than other East Asian women; for obesity the adjusted OR was 1.88 (95% CI 0.97 to 3.66), and for DM it was 1.62 (95% CI 0.65 to 4.02).


CONCLUSIONS
Filipina women have higher than expected rates of excess weight and chronic hypertension, underlining the need to consider Filipina and other East Asian women separately.
Fuller-Thomson
Esme
E
Factor-Inwentash Faculty of Social Work, Department of Family and Community Medicine, University of Toronto, Toronto ON.
Rotermann
Michelle
M
Health Analysis Division, Statistics Canada, Ottawa ON.
Ray
Joel G
JG
Departments of Medicine, Obstetrics, and Gynecology, and Health Policy Management and Evaluation, St. Michael's Hospital, University of Toronto, Toronto ON.
D000293:Adolescent; D000328:Adult; D002170:Canada; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010679:Philippines / Q000208:ethnology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D055815:Young Adult