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. 1993 Dec;83(12):1721–1725. doi: 10.2105/ajph.83.12.1721

Multiethnic variations in the pregnancy outcomes of military dependents.

G R Alexander 1, G Baruffi 1, J M Mor 1, E C Kieffer 1, T C Hulsey 1
PMCID: PMC1694936  PMID: 8259802

Abstract

OBJECTIVES. We examined the pregnancy outcomes of three ethnic groups: African-American Blacks, non-Hispanic Whites, and Filipinos. In an attempt to reduce ethnic dissimilarities in parental employment and access to health care, this investigation compared the single-live-birth outcomes of married, adult women who resided in the state of Hawaii and who indicated that their spouse was on active-duty status in the US military. METHODS. The data for this study were obtained from the 1979-1989 Hawaii vital-record file that provides linked live birth-infant death information. Multiple logistic regression was used to calculate odds ratios for the independent effects of maternal factors on low birthweight and neonatal mortality. RESULTS. Significant differences in maternal age, maternal education, paternal education, parity, hospital of delivery, and use of prenatal care were observed among the ethnic groups. The results of a logistic regression analysis of low birthweight indicated significantly higher risks for Filipinos and Blacks compared with Whites. For very low birthweight, only an increased risk for Blacks was observed. No ethnic differences in neonatal mortality were found. CONCLUSIONS. This investigation revealed more comparable infant mortality experiences among the ethnic groups in spite of persistent birthweight differences.

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Selected References

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  1. Adams M. M., Read J. A., Rawlings J. S., Harlass F. B., Sarno A. P., Rhodes P. H. Preterm delivery among black and white enlisted women in the United States Army. Obstet Gynecol. 1993 Jan;81(1):65–71. [PubMed] [Google Scholar]
  2. Alberman E. Are our babies becoming bigger? J R Soc Med. 1991 May;84(5):257–260. doi: 10.1177/014107689108400505. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Alexander G. R., Baruffi G., Mor J., Kieffer E. Maternal nativity status and pregnancy outcome among U.S.-born Filipinos. Soc Biol. 1992 Fall-Winter;39(3-4):278–284. doi: 10.1080/19485565.1992.9988822. [DOI] [PubMed] [Google Scholar]
  4. Alexander G. R., Cornely D. A. Racial disparities in pregnancy outcomes: the role of prenatal care utilization and maternal risk status. Am J Prev Med. 1987 Sep-Oct;3(5):254–261. [PubMed] [Google Scholar]
  5. Alexander G. R., Tompkins M. E., Altekruse J. M., Hornung C. A. Racial differences in the relation of birth weight and gestational age to neonatal mortality. Public Health Rep. 1985 Sep-Oct;100(5):539–547. [PMC free article] [PubMed] [Google Scholar]
  6. Alexander G. R., Tompkins M. E., Altekruse J. M., Hornung C. A. Racial differences in the relation of birth weight and gestational age to neonatal mortality. Public Health Rep. 1985 Sep-Oct;100(5):539–547. [PMC free article] [PubMed] [Google Scholar]
  7. Alexander G. R., Tompkins M. E., Cornely D. A. Gestational age reporting and preterm delivery. Public Health Rep. 1990 May-Jun;105(3):267–275. [PMC free article] [PubMed] [Google Scholar]
  8. Baruffi G., Alexander G., Novotny R. Causes of infant mortality in a multiethnic population. Asia Pac J Public Health. 1990;4(2-3):145–150. doi: 10.1177/101053959000400312. [DOI] [PubMed] [Google Scholar]
  9. Binkin N. J., Williams R. L., Hogue C. J., Chen P. M. Reducing black neonatal mortality. Will improvement in birth weight be enough? JAMA. 1985 Jan 18;253(3):372–375. doi: 10.1001/jama.253.3.372. [DOI] [PubMed] [Google Scholar]
  10. Cabral H., Fried L. E., Levenson S., Amaro H., Zuckerman B. Foreign-born and US-born black women: differences in health behaviors and birth outcomes. Am J Public Health. 1990 Jan;80(1):70–72. doi: 10.2105/ajph.80.1.70. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Emanuel I., Hale C. B., Berg C. J. Poor birth outcomes of American black women: an alternative explanation. J Public Health Policy. 1989 Autumn;10(3):299–308. [PubMed] [Google Scholar]
  12. Fichtner R. R., Sullivan K. M., Zyrkowski C. L., Trowbridge F. L. Racial/ethnic differences in smoking, other risk factors, and low birth weight among low-income pregnant women, 1978-1988. MMWR CDC Surveill Summ. 1990 Jul;39(3):13–21. [PubMed] [Google Scholar]
  13. Geronimus A. T. The effects of race, residence, and prenatal care on the relationship of maternal age to neonatal mortality. Am J Public Health. 1986 Dec;76(12):1416–1421. doi: 10.2105/ajph.76.12.1416. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Gould J. B., LeRoy S. Socioeconomic status and low birth weight: a racial comparison. Pediatrics. 1988 Dec;82(6):896–904. [PubMed] [Google Scholar]
  15. Greenberg D. N., Yoder B. A., Clark R. H., Butzin C. A., Null D. M., Jr Effect of maternal race on outcome of preterm infants in the military. Pediatrics. 1993 Mar;91(3):572–577. [PubMed] [Google Scholar]
  16. Hogue C. J., Yip R. Preterm delivery: can we lower the black infant's first hurdle? JAMA. 1989 Jul 28;262(4):548–550. [PubMed] [Google Scholar]
  17. Hulsey T. C., Levkoff A. H., Alexander G. R. Birth weights of infants of black and white mothers without pregnancy complications. Am J Obstet Gynecol. 1991 May;164(5 Pt 1):1299–1302. doi: 10.1016/0002-9378(91)90703-t. [DOI] [PubMed] [Google Scholar]
  18. Hulsey T. C., Levkoff A. H., Alexander G. R., Tompkins M. Differences in black and white infant birth weights: the role of maternal demographic factors and medical complications of pregnancy. South Med J. 1991 Apr;84(4):443–446. doi: 10.1097/00007611-199104000-00008. [DOI] [PubMed] [Google Scholar]
  19. Kessel S. S., Kleinman J. C., Koontz A. M., Hogue C. J., Berendes H. W. Racial differences in pregnancy outcomes. Clin Perinatol. 1988 Dec;15(4):745–754. [PubMed] [Google Scholar]
  20. Kleinman J. C., Fingerhut L. A., Prager K. Differences in infant mortality by race, nativity status, and other maternal characteristics. Am J Dis Child. 1991 Feb;145(2):194–199. doi: 10.1001/archpedi.1991.02160020086023. [DOI] [PubMed] [Google Scholar]
  21. Kleinman J. C. Infant mortality among racial/ethnic minority groups, 1983-1984. MMWR CDC Surveill Summ. 1990 Jul;39(3):31–39. [PubMed] [Google Scholar]
  22. Kleinman J. C., Kessel S. S. Racial differences in low birth weight. Trends and risk factors. N Engl J Med. 1987 Sep 17;317(12):749–753. doi: 10.1056/NEJM198709173171207. [DOI] [PubMed] [Google Scholar]
  23. Kleinman J. C., Madans J. H. The effects of maternal smoking, physical stature, and educational attainment on the incidence of low birth weight. Am J Epidemiol. 1985 Jun;121(6):843–855. doi: 10.1093/oxfordjournals.aje.a114055. [DOI] [PubMed] [Google Scholar]
  24. Kugler J. P., Connell F. A., Henley C. E. Lack of difference in neonatal mortality between blacks and whites served by the same medical care system. J Fam Pract. 1990 Mar;30(3):281–288. [PubMed] [Google Scholar]
  25. Murray J. L., Bernfield M. The differential effect of prenatal care on the incidence of low birth weight among blacks and whites in a prepaid health care plan. N Engl J Med. 1988 Nov 24;319(21):1385–1391. doi: 10.1056/NEJM198811243192105. [DOI] [PubMed] [Google Scholar]
  26. Rawlings J. S., Weir M. R. Race- and rank-specific infant mortality in a US military population. Am J Dis Child. 1992 Mar;146(3):313–316. doi: 10.1001/archpedi.1992.02160150053020. [DOI] [PubMed] [Google Scholar]
  27. Schoendorf K. C., Hogue C. J., Kleinman J. C., Rowley D. Mortality among infants of black as compared with white college-educated parents. N Engl J Med. 1992 Jun 4;326(23):1522–1526. doi: 10.1056/NEJM199206043262303. [DOI] [PubMed] [Google Scholar]
  28. Wilcox A., Russell I. Why small black infants have a lower mortality rate than small white infants: the case for population-specific standards for birth weight. J Pediatr. 1990 Jan;116(1):7–10. doi: 10.1016/s0022-3476(05)81638-5. [DOI] [PubMed] [Google Scholar]
  29. Wise P. H., Kotelchuck M., Wilson M. L., Mills M. Racial and socioeconomic disparities in childhood mortality in Boston. N Engl J Med. 1985 Aug 8;313(6):360–366. doi: 10.1056/NEJM198508083130605. [DOI] [PubMed] [Google Scholar]

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