title: Preterm birth among the Hmong, other Asian subgroups and non-Hispanic whites in California.
abstract: BACKGROUND
  We investigated very preterm (VPTB) and preterm birth (PTB) risk among Hmong women relative to non-Hispanic whites and other Asian subgroups. We also examined the maternal education health gradient across subgroups.
  
  
  METHODS
  California birth record data (2002-2004) were used to analyze 568,652 singleton births to white and Asian women. Pearson Chi-square and logistic regression were used to assess variation in maternal characteristics and VPTB/PTB risk by subgroup.
  
  
  RESULTS
  White, Chinese, Japanese, Korean, Asian Indian, and Vietnamese women had 36-59% lower odds of VPTB and 30-56% lower odds of PTB than Hmong women. Controls for covariates did not substantially diminish these disparities. Cambodian, Filipino and Lao/Thai women's odds of VPTB were similar to that of Hmong women. But they had higher adjusted odds of PTB compared to the Hmong. There was heterogeneity in the educational gradient of PTB, with significant differences between the least and most educated women among whites, Chinese, Japanese, Asian Indians, Cambodians, and Laoians/Thais. Maternal education was not associated with PTB for Hmong, Vietnamese and Korean women, however.
  
  
  CONCLUSIONS
  Studies of Hmong infant health from the 1980s, the decade immediately following the group's mass migration to the US, found no significant differences in adverse birth outcomes between Hmong and white women. By the early 2000s, however, the disparities in VPTB and PTB between Hmong and white women, as well as between Hmong and other Asian women had become substantial. Moreover, despite gains in post-secondary education among childbearing-age Hmong women, the returns to education for the Hmong are negligible. Higher educational attainment does not confer the same health benefits for Hmong women as it does for whites and other Asian subgroups.
authors: Sociology Department, McGill University, 855 Sherbrooke Street West, Montreal, Quebec, H3A 2 T7, Canada. zoua.vang@mcgill.ca.
authors: Zoua M
authors: ZM
authors: Vang
authors: Sociology Department, University of Pennsylvania, 3718 Locust Walk, McNeil Building, Ste. 243, Philadelphia, PA, 19104-6299, USA. popelo@pop.upenn.edu.
authors: Irma T
authors: IT
authors: Elo
authors: Department of Obstetrics and Gynecology, McGill University, RI-MUHC, 1001 Decarie Blvd, Montreal, Quebec, H4A 3 J1, Canada. makoto.nagano@muhc.mcgill.ca.
authors: Makoto
authors: M
authors: Nagano
mesh_terms: D000328:Adult; D001213:Asian / Q000706:statistics & numerical data*; D002140:California / Q000453:epidemiology; D002160:Cambodia / Q000208:ethnology; D002681:China / Q000208:ethnology; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000208:ethnology*; D004522:Educational Status; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007194:India / Q000208:ethnology; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D007564:Japan / Q000208:ethnology; D007723:Korea / Q000208:ethnology; D007812:Laos / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010679:Philippines / Q000208:ethnology; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000208:ethnology*; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology / Q000208:ethnology*; D012307:Risk Factors; D013785:Thailand / Q000208:ethnology; D014744:Vietnam / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult