Background: Recent studies suggest that in community-level studies, Latino women highly acculturated to the U.S., experience elevated rates of low birthweight. This study examines the association of acculturation and cesarean section among low-risk, low-income Hispanic women in San Diego County.
Methods: Data were used from the San Diego Birth Center Study, designed to evaluate an alternative model for enhanced perinatal services. The sample of 2264 Hispanic women was divided into three groups: nulliparas and multiparas with and without a history of cesarean section. For each of these three groups, the relationship between acculturation and cesarean section was assessed using multivariate regression analysis. Primary language and country of origin were used to assess acculturation. Mexican-born Spanish speakers were considered to be low-acculturated, while U.S.-born English speakers were considered to be high-acculturated.
Results: In the nulliparas group, the adjusted risk of cesarean section for the high-acculturated women was less than the risk for low-acculturated women (OR 0.5, 95%CI 0.3-0.8). However, in both multiparas groups (with and without history of cesarean section), the adjusted risk of cesarean section for the high-acculturated women exceeded the risk for the low-acculturated women (0R 3.1, 95%CI 1.1-8.6 & OR 1.9, 95%CI 0.9-4.1, respectively).
Conclusions: Acculturation, which is a proxy for cultural beliefs and behaviors, may not affect pregnancy outcomes uniformly. The subgroups (nulliparas and multiparas women) may exhibit different health behaviors. In order to improve pregnancy outcomes, acculturation needs to be understood, as a process, which directly affects risk behaviors and indirectly affects health outcomes.
Learning Objectives: Participant should be able to 1) understand two dimensions of acculturation, 2) describe the association of acculturation and cesarean section 3) discuss opportunities to use this knowledge to improve pregnancy outcomes.
Keywords: Pregnancy Outcomes, Latinas
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.