title: Maternal risk factors and perinatal outcomes among pacific islander groups in Hawaii: a retrospective cohort study using statewide hospital data.
abstract: BACKGROUND
  Studies suggest Pacific Islander women have disparate rates of preterm birth, primary cesarean delivery, preeclampsia, gestational diabetes, and low birthweight infants. However, data is limited. In order to improve the health of Pacific Islanders, it is essential to better understand differences in obstetric outcomes in this diverse population
  
  
  METHODS
  This study compared perinatal outcomes between Pacific Islander (9,646) and White (n = 5,510) women who delivered a singleton liveborn in any Hawaii hospital from January 2010 to December 2011 using the Hawaii Health Information Corporation (HHIC) database. Pacific Islanders were disaggregated into the following groups: Native Hawaiian, Samoan, Micronesian, and Other Pacific Islanders. Perinatal outcomes (e.g. hypertensive diseases, birthweight, mode of delivery) were compared using multivariable logistic models controlling for relevant sociodemographic and health risk factors (e.g. age and payer type).
  
  
  RESULTS
  Significant differences in perinatal outcomes between Pacific Islander and White women and newborns were noted. All Pacific Islander groups had an increased risk of hypertension. Outcome differences were also seen between Pacific Islanders groups. Native Hawaiians had the highest risk of low birthweight infants, Samoans had the highest risk of macrosomic infants and Micronesians had the highest risk of cesarean delivery.
  
  
  CONCLUSIONS
  Important differences in perinatal outcomes among Pacific Islanders exist. It is important to examine Pacific Islander populations separately in future research, public health interventions, and policy.
authors.affiliation: Department of Obstetrics, Gynecology and Women's Health, University of Hawaii, 1319 Punahou Street Suite #824, Honolulu, HI, 96826, USA. annchang@hawaii.edu.
authors.forename: Ann Lee
authors.initials: AL
authors.lastname: Chang
authors.affiliation: Office of Public Health Studies, University of Hawaii, 1960 East-west Road, Biomed D-204, Honolulu, HI, 96822, USA. ehurwitz@hawaii.edu.
authors.forename: Eric
authors.initials: E
authors.lastname: Hurwitz
authors.affiliation: Hawaii Health Information Corporation, 733 Bishop Street, Suite 1870, Honolulu, HI, 96813, USA. jmiyamura@hhic.org.
authors.forename: Jill
authors.initials: J
authors.lastname: Miyamura
authors.affiliation: Department of Obstetrics, Gynecology and Women's Health, University of Hawaii, 1319 Punahou Street Suite #824, Honolulu, HI, 96826, USA. blissk@hawaii.edu.
authors.forename: Bliss
authors.initials: B
authors.lastname: Kaneshiro
authors.affiliation: Office of Public Health Studies, University of Hawaii, 1960 East-west Road, Biomed D-204, Honolulu, HI, 96822, USA. tsentell@hawaii.edu.
authors.forename: Tetine
authors.initials: T
authors.lastname: Sentell
mesh_terms: D000328:Adult; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000208:ethnology*; D005260:Female; D005320:Fetal Macrosomia / Q000208:ethnology; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000208:ethnology*; D007230:Infant, Low Birth Weight; D000068097:Maternal Health / Q000208:ethnology; D008849:Micronesia / Q000208:ethnology; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data*; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D018947:Samoa / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult