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01-11-2019 | Premature Birth

Adverse Pregnancy and Neonatal Outcomes Among Marshallese Women Living in the United States

Authors: Wendy N. Nembhard, Britni L. Ayers, R. Thomas Collins, Xiaoyi Shan, Nader Z. Rabie, Di Chang, James M. Robbins, Pearl A. McElfish

Published in: Maternal and Child Health Journal | Issue 11/2019

Abstract

Objective Despite heterogeneity among Pacific Islanders, most studies aggregate them regardless of origin. Thus, limited information is available about perinatal outcomes among various subgroups of Pacific Islanders in the United States, including immigrants from the Republic of the Marshall Islands. We sought to evaluate perinatal outcomes among Marshallese women. Methods We conducted a cross-sectional study of women with at least one singleton live birth between 1997 and 2013 in two Arkansas counties using birth certificate data from the Arkansas Department of Health. Unadjusted and adjusted prevalence ratios (PR) and 95% confidence intervals (CI) were calculated from modified Poisson regression models. Results Of the 91,662 singleton births in both counties during the study period, 2488 were to Marshallese women. In adjusted analyses, Marshallese women had higher prevalence of “other medical risk factors” (PR = 1.47; 95% CI 1.30, 1.65) than NH White women. Marshallese women had higher rates of precipitous labor and fetal distress during labor compared to NH White women (PR = 2.65; 95% CI 2.22, 3.17 and 1.89; 95% CI 1.62, 2.21, respectively). Marshallese were also more likely to have tocolysis (PR = 1.43; 95% CI 1.16, 1.76), forceps (PR = 1.68; 95% CI 1.16, 2.43) or vacuum (PR = 1.89; 95% CI 1.60, 2.22) used in delivery and cesarean section (PR = 1.13; 95% CI 1.01, 1.27). Marshallese infants had higher rates of anemia (PR = 3.10; 95% CI 2.01, 4.77), birth injury (PR = 2.13; 95% CI 1.50, 3.03), assisted ventilation < 30 min (PR = 2.11; 95% CI 1.64, 2.71), preterm birth (PR = 1.67; 95% CI 1.50, 1.83), and small-for-gestational age (PR = 1.25; 95% CI 1.12, 1.39) than NH White infants. Conclusions Marshallese women and infants had higher rates of adverse perinatal outcomes compared to their NH White counterparts. Additional studies are needed to determine if perinatal outcomes among the Marshallese differed from other Pacific Islander subgroups.

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Title: Adverse Pregnancy and Neonatal Outcomes Among Marshallese Women Living in the United States
Authors: Wendy N. Nembhard
Britni L. Ayers
R. Thomas Collins
Xiaoyi Shan
Nader Z. Rabie
Di Chang
James M. Robbins
Pearl A. McElfish
Publication date: 01-11-2019
Publisher: Springer US
Keywords: Premature Birth
Prenatal Care
Published in: Maternal and Child Health Journal / Issue 11/2019
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-019-02775-8

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