Assessing the role of acculturation, social support, and stress on birth outcomes among hispanic women enrolled in familias sanas

Background: Familias Sanas (Healthy Families) randomized low income, immigrant Hispanic mothers to either a bicultural and bilingual ‘prenatal partner' or usual care. This secondary data analyses identifies the associations between the predictor variables of acculturation, social support, and stress on maternal health and birth outcomes in the Familias Sanas study participants.

Methods: This cohort study (N=440) assesses: 1) Relationships between the three predictor variables; 2) Associations between the predictor variables to gestational age and birth weight; 3) Cumulative correlations between the three predictors and outcome variables.

Results: Based on linear regression, Hispanicism predicted lower stress (p=0.02, β=-0.134) and Americanism significantly predicted higher stress (p<0.01, β=0.239). Both acculturation measures were positively correlated with social support (Hispanicism: r=0.179, p<0.01; Americanism: r=0.154, p<0.01). Social support was negatively correlated with stress (p<0.01, r=-.285), indicating higher levels of social support are correlated with lower stress. Stress significantly predicted lower birth weight (p<0.05, β= -.114). The Sobel test to detect the indirect effect of acculturation on birth weight through the mediator variable of stress was not significant.

Conclusions: We found relationships of acculturation with stress which in turn was associated with lower birth weight. Although there is strong evidence for the associations between acculturation and birth weight in the literature, we did not find this in our study. Nor did we find an indirect effect of acculturation through stress although this could be due to small sample size. Further research studying the relationship of acculturation, social support, and stress on birth outcomes is warranted.