U.S. medicine may be the envy of the world, but Hispanic women's risk of giving birth prematurely increases the longer they live here, according to a Houston-area study.
The study, led by University of Texas Medical Branch at Galveston researchers, found that Hispanic immigrants have a low risk of delivering premature babies in the immediate years after arriving in the United States but higher risks over time.
"We were surprised by the study's findings," said Dr. Radek Bukowski, a UTMB professor of obstetrics and gynecology and the study's principal investigator. "We know that immigrants generally have good health, but we didn't expect Hispanic women's risk of premature births to increase so significantly once here."
Bukowski's study, presented Thursday at the annual meeting of the Society for Maternal-Fetal Medicine in Dallas, found the risk not only grew as Hispanic immigrants resided in the United States, but that it was highest among Hispanic women born here.
The prevalence of premature birth was 3.4 percent among Hispanic women who had lived in the United States for less than 10 years, 7.4 percent among those here for 10 or more years and nearly 10 percent among those born here.
Extended family's role
The increased risk had nothing to do with the woman's age, body mass index, marital status, toxic exposures, diet, key health indicators or socioeconomic status. The increased risk showed up even after researchers adjusted for those factors.
"I think what gets lost in the U.S. is the extended family dynamic Hispanic mothers had in their native land," said Norma Olvera, University of Houston professor and president of the Hispanic Health Coalition. "They miss the support provided by their parents, such as making sure they eat and rest properly."
Claudia Kolker, a Houston journalist who has researched the cultural traditions of immigrants in the United States, said Bukowski's study may be another manifestation of the "Hispanic health paradox," which emerged when another UTMB professor found that Latinos in the Southwest lived longer than native-born Americans.
"Although no one has nailed it down, there is some consensus about reasons for longevity, and I would guess that it also applies to pregnancy," said Kolker, author of The Immigrant Advantage: What We Can Learn from Newcomers to America about Health, Happiness and Hope.
People who walk across borders, Kolker said, tend to be strong and to have a more optimistic attitude than people born here.
Her research on immigrants from the Mexican state of Chiapas found that families insisted new mothers have 40 days of bed rest, reflecting "an attitude that we have to take care of these women. They're careful about what they eat, they're respected and treasured and protected."
This attitude, Kolker said, might carry over to prenatal care as well.
Manisha Gandhi, a Baylor College of Medicine specialist in maternal-fetal medicine, noted experts already have difficulty determining the role played by hormonal imbalances, stress, diet, infections and the environment.
Not better in U.S.
But she called the study intriguing and said it shows the assumption that health conditions are necessarily better in the United States isn't correct.
Despite improvements in prenatal care, more than 500,000 U.S. babies a year are born before 37 weeks. That's roughly 1 in 8 deliveries. The rate is highest, 17.5 percent, among black newborns, says the National Center for Health Statistics.
Such early labor puts babies at risk for all manner of health problems, from breathing difficulties to cerebral palsy to intellectual disability. Although there are known risk factors -- carrying multiple babies, previous preterm births, cigarette or alcohol use -- the cause is unknown about half the time.
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