Document Detail

Prenatal care, birth outcomes and newborn hospitalization costs: patterns among Hispanics in New Jersey.
MedLine Citation:
PMID:  9711457     Owner:  NLM     Status:  MEDLINE    
CONTEXT: With the influx of Latin American immigrants to the United States and the relatively high fertility of Hispanic women, the importance of understanding patterns of birth outcomes within the heterogeneous Hispanic community is growing. METHODS: Vital statistics data linked with hospital discharge files for single, liveborn infants delivered in New Jersey to state residents in 1989 and 1990 are used to examine the effects of maternal birthplace and Hispanic ethnicity on early initiation of prenatal care, low birth weight, infant mortality and newborn hospital costs. Multivariate analyses control for a range of demographic, economic, behavioral and medical factors. RESULTS: White women of Puerto Rican descent have a significantly higher risk than both non-Hispanic whites and other Hispanic whites of having a low-birth-weight baby. However, their infants do not have an increased risk of mortality, and newborn hospitalization costs are not elevated for this group. Mexican-born white women begin prenatal care later than their U.S.-born counterparts, but do not have worse birth outcomes. The sharpest contrasts are not among Hispanics but between non-Hispanic black and non-Hispanic white women born in the same place. CONCLUSIONS: Ethnicity and birthplace affect prenatal care and birth outcomes but are probably not as significant as racial differences. Poor outcomes without elevated newborn costs may indicate less access to high-quality neonatal care among some ethnic groups.
Vital statistics data linked with hospital discharge files for single, live-born infants delivered in New Jersey (US) in 1989-90 were used to examine the effects of Hispanic ethnicity on prenatal care utilization, low birth weight, infant mortality, and newborn hospitalization costs. The findings indicate that disparities by race may be at least as important as variations in birthplace and ethnicity. Puerto Rican White women who gave birth in New Jersey were twice as likely, relative to their US-born non-Hispanic White counterparts, to have a low-birth-weight infant and to have an infant who died in the first year of life. In addition, their newborn hospitalization costs were 25% higher than those of US-born non-Hispanic White women. Women of Puerto Rican descent, regardless of whether they were born in the US, initiated prenatal care later than all other Whites, except the infants born in Mexico, and their infants had the highest rates of low birth weight and mortality among all Whites. Although the multivariate results indicated that ethnic Puerto Rican Black women begin prenatal care earlier and have better birth outcomes than non-Hispanic Blacks, the descriptive statistics showed that Puerto Rican Blacks and Whites have similar levels of prenatal care use and birth outcomes. Enhanced understanding of the sources of these racial disparities is important for the design of policies to improve birth outcomes. Poor outcomes without concomitant increases in hospitalization costs may be a sign of low access to high-quality neonatal care.
N E Reichman; G M Kenney
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Family planning perspectives     Volume:  30     ISSN:  0014-7354     ISO Abbreviation:  Fam Plann Perspect     Publication Date:    1998 Jul-Aug
Date Detail:
Created Date:  1998-11-16     Completed Date:  1998-11-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0241370     Medline TA:  Fam Plann Perspect     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  182-7, 200     Citation Subset:  IM; J    
Office of Population Research, Princeton University, NJ, USA.
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MeSH Terms
African Americans / statistics & numerical data
Discriminant Analysis
Emigration and Immigration / statistics & numerical data
European Continental Ancestry Group / statistics & numerical data
Hispanic Americans / statistics & numerical data*
Hospital Costs / statistics & numerical data*
Infant Mortality
Infant, Low Birth Weight
Infant, Newborn
Multivariate Analysis
New Jersey / epidemiology
Pregnancy Outcome / epidemiology*
Prenatal Care / utilization*
Regression Analysis
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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