Perinatal outcomes among Pacific Islanders in Hawaii

Objective: The purpose of this study was to examine risk factors for poor perinatal outcomes and to examine perinatal outcomes among Pacific Islander groups in Hawaii. Methods: This was a retrospective study of all civilian deliveries and newborn admissions in Hawaii from 2010-2011 using the Hawaii Health Information Corporation (HHIC) database. Pacific Islanders were divided into the following subgroups: Native Hawaiian, Samoan, Micronesian, and Other Pacific Islander. Whites were used as the comparison group. Obstetric outcomes included gestational diabetes, chorioamnionitis/major puerperal infections, pregnancy-related hypertension, low birthweight, macrosomia, preterm delivery, cesarean delivery and operative vaginal delivery. Logistic regression was used to estimate adjusted associations (odds ratios) by race/ethnicity for risk factors and perinatal outcomes controlling for relevant factors such as insurance. Results: Compared to Whites, Pacific Islander groups overall had sociodemographic and medical conditions that placed them at increased risk for poor obstetric outcomes. There were significant differences in perinatal outcomes between the Pacific Islander groups. All Pacific Islander groups had increased risk of gestational diabetes and pregnancy-related hypertension compared to Whites. Native Hawaiians had the highest risk for preterm birth. Samoans had the highest risk of birthweight >4000 grams yet the lowest risk of cesarean section. Micronesians had the highest risk for cesarean and operative vaginal deliveries. Conclusions: Significant differences in risk factors for poor obstetric outcomes as well as in perinatal outcomes among Pacific Islanders exist. It is important to examine Pacific Islander populations separately in future research, public health interventions, and policy.