Acculturation and maternal health behaviors: findings from the Massachusetts birth certificate.
Acculturation and maternal health behaviors: findings from the Massachusetts birth certificate.
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文化适应和孕产妇健康行为：马萨诸塞州出生证明的调查结果。
DOI：
10.1016/j.amepre.2014.02.015
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发表时间：
2014
影响因子：
5.5
通讯作者：
Cohen,BruceB
中科院分区：
文献类型：
--
作者：
Hawkins,SummerSherburne;Gillman,MatthewW;Shafer,EmilyF;Cohen,BruceB
虽然先前的研究表明，母亲的健康行为因种族/民族和文化适应而存在差异，但这些模式在新移民人群中是否明显尚不清楚。目的调查马萨诸塞州各主要民族中母亲孕期吸烟和母乳喂养开始之间的关系。方法数据来自1996-2009年来自31个民族的1067,375名母亲的活产标准证书。母亲们报告了她们在怀孕期间是否吸烟，分娩机构记录了母亲是否开始母乳喂养。文化适应代理结合了母亲的出生国和语言偏好：在美国出生的、在外国出生的说英语的和在外国出生的非说英语的。对于每个民族，调整后的Logistic回归模型被用来检验文化适应指标和母亲是否吸烟或开始母乳喂养之间的关联。对2012年至2013年的数据进行了分析。结果外国出生的母亲拥有高中学历或私人保险的比例低于美国出生的母亲。然而，与美国出生的母亲相比，英国人(AORS=0.07-0.93)或非英语国家的母亲(AORS=0.01-0.36)在怀孕期间吸烟的可能性较小。与美国出生的母亲相比，出生在国外的英国人(AORS=1.22-6.52)或非英语国家的母亲(AORS=1.35-10.12)也更有可能开始母乳喂养，但一些亚裔母亲除外。结论对于大多数被研究的种族来说，外国出生的母亲吸烟较少，母乳喂养较多，这一一致性表明，对于大多数被研究的种族来说，美国的文化适应导致了较差的母亲健康行为。
BackgroundAlthough prior studies have shown disparities in maternal health behaviors according to race/ethnicity and acculturation, whether these patterns are evident among new immigrant populations remains unclear.PurposeTo examine the associations among proxies of acculturation and maternal smoking during pregnancy and breastfeeding initiation within each major ethnic group in Massachusetts.MethodsData were from the Standard Certificate of Live Births on 1,067,375 babies by mothers from 31 ethnic groups for 1996–2009. Mothers reported whether they smoked during pregnancy and the birth facility recorded whether mothers started breastfeeding. The acculturation proxy combined mothers’ country of birth and language preference: U.S.-born, foreign-born English-speaking, and foreign-born non-English speaking. For each ethnic group, adjusted logistic regression models were used to examine associations between the acculturation proxy and whether mothers smoked or initiated breastfeeding. Data were analyzed from 2012 to 2013.ResultsA lower proportion of foreign-born mothers had a high school degree or private insurance than U.S.-born mothers. However, foreign-born mothers who were English (range of AORs=0.07–0.93) or non-English speakers (AORs=0.01–0.36) were less likely to smoke during pregnancy than their U.S.-born counterparts. Foreign-born mothers who were English (AORs=1.22–6.52) or non-English speakers (AORs=1.35–10.12) were also more likely to initiate breastfeeding compared to U.S.-born mothers, except for some mothers with Asian ethnicities.ConclusionsThe consistency of the associations of being foreign-born with less smoking and more breastfeeding suggests that for the majority of ethnic groups studied, acculturation in the U.S. results in poorer maternal health behaviors.