Acculturation and perinatal health outcomes among rural women of Mexican descent.

OBJECTIVE: The purpose of this research was to utilize medical records to describe and compare prenatal, labor and delivery, and postpartum outcomes of rural women of Mexican descent on the basis of acculturation as measured by language spoken and their place of birth, separately, and then by the two factors combined in the form of the Acculturation Index (AI). DESIGN: Not given. SETTING: Three rural Northern and Central California community hospitals. POPULATION: Pregnant women who had self-identified as 'Hispanic' and who had delivered a child between January 1992 and July 1994. INTERVENTIONS: The prenatal and birth records of 773 women who were born either in the United States or in Mexico were used in the analysis. A total of 315 charts for women born in the United States were identified and included in the sample. Over 5000 charts for women born in Mexico were identified and the staff randomly selected every 10th chart to obtain a total of 466. The AI was used to divide the sample into three groups: 1) Mexico-oriented, 2) U.S.-oriented, and 3) and intermediate, consisting of women who were U.S.-born Spanish speakers or Mexico-born English speakers. Labor, delivery, and postpartum complications were derived from item 32 of the Medical Data Supplement Work Sheet. Data were gathered from the medical records and entered into computer files, then statistically analyzed. MAIN OUTCOME MEASURE(S): There was a statistically significant difference in age among the three AI groups. The women who were in the Mexico-oriented group were significantly older than the women in the U.S.-oriented group. When the women were compared by language spoken there were no statistically significant differences in prenatal complications. However, when the women were compared according to place of birth, the women who were born in the U.S. were more likely to have complications than those who were born in Mexico. The greatest percentage of women who gained too much weight was from the U.S.-oriented group as compared to the Intermediate group. There were no statistically significant differences in the number of labor and delivery outcomes when the women were compared by language spoken, place of birth, or the AI. However, when compared by place of birth, more U.S.-born women had a Cesarean birth compared to Mexico-born women. RESULTS/CONCLUSIONS: Although comparisons of the women based on birthplace along also showed that U.S.-born women of this study had more perinatal problems than Mexico-born women, some information about the subgroup of women who were born in the United States but spoke Spanish would have remained hidden without the use of the AI. In contrast to the use of place of birth and the AI as indicators of acculturation, the use of language spoken was not associated with prenatal or labor and delivery outcomes. However, all three were comparable correlates of postpartum outcomes. The findings of this study challenge the tendency to assume that all women of Mexican descent fit one generalized, monolithic health profile of 'Latina women'. The variations in this study underscore the reality that women of Mexican descent differ significantly among themselves. [CINAHL abstract] [ABSTRACT FROM AUTHOR]