title: Acculturation and Adverse Birth Outcomes in a Predominantly Puerto Rican Population.
abstract: Introduction Latinas in the United States on average have poorer birth outcomes than Whites, yet considerable heterogeneity exists within Latinas. Puerto Ricans have some of the highest rates of adverse outcomes and are understudied. The goal of this study was to determine if acculturation was associated with adverse birth outcomes in a predominantly Puerto Rican population. Methods We conducted a secondary analysis of Proyecto Buena Salud, a prospective cohort study conducted from 2006 to 2011. A convenience sample of pregnant Latina women were recruited from a tertiary care hospital in Massachusetts. Acculturation was measured in early pregnancy; directly via the Psychological Acculturation Scale, and via proxies of language preference and generation in the United States. Birth outcomes (gestational age and birthweight) were abstracted from medical records (n = 1362). Results After adjustment, psychological acculturation, language preference, and generation was not associated with odds of preterm birth. However, every unit increase in psychological acculturation score was associated with an increase in gestational age of 0.22 weeks (SE = 0.1, p = 0.04) among all births. Women who preferred to speak Spanish (β = -0.39, SE = 0.2, p = 0.02) and who were first generation in the US (β = -0.33, SE = 0.1, p = 0.02) had significantly lower gestational ages than women who preferred English or who were later generation, respectively. Similarly, women who were first generation had babies who weighed 76.11 g less (SE = 35.2, p = 0.03) than women who were later generation. Discussion We observed a small, but statistically significant adverse impact of low acculturation on gestational age and birthweight in this predominantly Puerto Rican population.
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2000, New Orleans, LA, 70112, USA. barcelonaveronica@yahoo.com.|Yale School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA. barcelonaveronica@yahoo.com.
authors.forename: Veronica
authors.identifier: 0000-0003-3070-1716
authors.initials: V
authors.lastname: Barcelona de Mendoza
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2000, New Orleans, LA, 70112, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Harville
authors.affiliation: Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2300, New Orleans, LA, 70112, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Theall
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2000, New Orleans, LA, 70112, USA.
authors.forename: Pierre
authors.initials: P
authors.lastname: Buekens
authors.affiliation: University of Massachusetts- Amherst, School of Public Health and Health Sciences, 405 Arnold House, 715 N. Pleasant Street, Amherst, MA, 01003, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Chasan-Taber
mesh_terms: D000069:Acculturation; D000293:Adolescent; D005260:Female; D005865:Gestational Age; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008404:Massachusetts / Q000453:epidemiology; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care; D011159:Population Surveillance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology*; D011256:Pregnancy Outcome / Q000208:ethnology*; D047928:Premature Birth / Q000453:epidemiology / Q000208:ethnology*; D011446:Prospective Studies; D011647:Puerto Rico / Q000208:ethnology; D055815:Young Adult
keywords: Acculturation; Latino; Preterm birth; Small-for-gestational-age