title: Maternal language and adverse birth outcomes in a statewide analysis.
abstract: Limited English proficiency is associated with disparities across diverse health outcomes. However, evidence regarding adverse birth outcomes across languages is limited, particularly among U.S. Asian and Pacific Islander populations. The study goal was to consider the relationship of maternal language to birth outcomes using statewide hospitalization data. Detailed discharge data from Hawaii childbirth hospitalizations from 2012 (n = 11,419) were compared by maternal language (English language or not) for adverse outcomes using descriptive and multivariable log-binomial regression models, controlling for race/ethnicity, age group, and payer. Ten percent of mothers spoke a language other than English; 93% of these spoke an Asian or Pacific Islander language. In multivariable models, compared to English speakers, non-English speakers had significantly higher risk (adjusted relative risk [ARR]: 2.02; 95% confidence interval [CI]: 1.34-3.04) of obstetric trauma in vaginal deliveries without instrumentation. Some significant variation was seen by language for other birth outcomes, including an increased rate of primary Caesarean sections and vaginal births after Caesarean, among non-English speakers. Non-English speakers had approximately two times higher risk of having an obstetric trauma during a vaginal birth when other factors, including race/ethnicity, were controlled. Non-English speakers also had higher rates of potentially high-risk deliveries.
authors.affiliation: a Office of Public Health Studies , University of Hawaii at Manoa , Honolulu , Hawaii , USA.
authors.forename: Tetine
authors.initials: T
authors.lastname: Sentell
authors.affiliation: b Department of Obstetrics, Gynecology, and Women's Health , John A. Burns School of Medicine, University of Hawaii , Honolulu , Hawaii , USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Chang
authors.affiliation: c Biostatistics Core, John A. Burns School of Medicine , University of Hawaii , Honolulu , Hawaii , USA.
authors.forename: Hyeong Jun
authors.initials: HJ
authors.lastname: Ahn
authors.affiliation: d Hawaii Health Information Corporation , Honolulu , Hawaii , USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Miyamura
mesh_terms: D000328:Adult; D001208:Asia / Q000208:ethnology; D044466:Asian People; D003144:Communication Barriers; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D054624:Health Status Disparities; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007802:Language; D008297:Male; D009035:Mothers; D015999:Multivariate Analysis; D044468:Native Hawaiian or Pacific Islander; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010139:Pacific Islands / Q000208:ethnology; D036801:Parturition; D018743:Perinatal Care; D011159:Population Surveillance; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology / Q000208:ethnology*; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Asian; English proficiency; Pacific Islander; birth outcomes; obstetric trauma