Transactions of the Twenty-Sixth Annual Meeting of the Society for Maternal-Fetal Medicine
Perinatal outcomes among Asian American and Pacific Islander women

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Objective

The purpose of this study was to examine perinatal outcomes between Asian American and Pacific Islander subgroups.

Study design

This is a retrospective study of all Asian American/Pacific Islander women who were delivered at Stanford University Medical Center from 1998 to 2003. Asian American women were subdivided into the following groups: Indian/Pakistani, Chinese, Filipino, Japanese, Korean, Pacific Islanders (individuals from Tonga, Samoa, Guam, or Polynesia), and Vietnamese. Perinatal outcomes included gestational hypertension/preeclampsia, gestational diabetes mellitus, preterm delivery, cesarean delivery, birthweight <2500 g, and birthweight >4000 g.

Results

In the study population of 3779 Asian American women, there were statistically significant differences (P < .01) between most of the outcomes that were examined. Filipina women had the highest risk of gestational hypertension/preeclampsia (adjusted odds ratio, 2.21); Indian/Pakistani women had the highest risk of preterm delivery (adjusted odds ratio, 1.67), gestational diabetes mellitus (adjusted odds ratio, 1.39), and low birthweight at term (adjusted odds ratio, 2.30); and Pacific Islander women had the highest risk of macrosomia (adjusted odds ratio, 3.67).

Conclusion

Significant differences in perinatal outcomes exist between subgroups of the Asian American and Pacific Islander community. Future research on race/ethnicity and perinatal outcomes should examine heterogeneity among these groups before collapsing these individual subgroups into the larger group “Asian.” Individuals should be counseled regarding perinatal risk according to their specific Asian subgroup.

Section snippets

Material and methods

We conducted a retrospective cohort study of AAPI women who were delivered at Stanford University Medical Center between 1998 and 2003. Ethnicity designations were self-reported by women on admission to labor and delivery. Demographic data and information regarding perinatal and neonatal outcomes were obtained from the Stanford Perinatal Database, which is generated from nursing intake forms, trained chart reviewers, and birth recorder interviews. Institutional Review Board approval was

Results

In the study period, there were 3779 deliveries to AAPI women who met the study criteria. The AAPI subgroups differed with respect to maternal age, maternal education, number of prenatal visits, parity, and insurance status (Table I).

Significant differences (P < .001) were noted among most of the perinatal outcomes that were measured, except GDM and cesarean delivery (Table II). The incidence of gestational hypertension/preeclampsia was highest among Filipino American women (6.3%; P < .001).

Comment

Our study demonstrated that significant differences exist between subgroups of the AAPI community; our findings are similar to other studies that have shown that disaggregating the Asian American population reveals important differences among each individual Asian American subgroup. We extend these findings to a variety of obstetric outcomes, particularly among the little studied Asian American subgroups of Indian and Pacific Islander American women.

The finding of increased incidence of

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Supported in part by the National Institute of Child Health and Human Development, Grant #HD01262, as a Women's Reproductive Health Research Scholar (A.B.C.).

Presented at the 26th Annual Meeting of the Society for Maternal Fetal Medicine, January 30-February 4, 2006, Miami, FL

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