UB Researchers Find Differences In Birth Outcomes Among Women In Hispanic Subgroups

BUFFALO, N.Y. -- Studies being conducted by researchers at the University at Buffalo of low birth weight and premature births among Hispanic mothers, and of failure rates and side effects of IUD use among women from the Jilin Province of China, are adding to information about the state of female reproductive health.

Both studies are being presented at the annual meeting of the Society for Epidemiologic Research held June 12-15 in Boston.

The study of Hispanic mothers examined rates of low birth weights and pre-term births among 5,547 Hispanic mothers in New York State, excluding New York City. Researchers compared the rates of Hispanics with those of non-Hispanic blacks and whites, and looked at the differences in rates between Hispanics of Puerto-Rican, Mexican, Cuban, Central/South American and other Hispanic ancestry.

Results showed that the risk of delivering a baby of low birth weight was comparable among Hispanics and whites, but Hispanic mothers were at higher risk of pre-term delivery than white mothers. African-Americans had the highest rates of both low-birth-weight babies and pre-term deliveries, a finding mirroring earlier research.

The most interesting findings came when researchers, headed by Laurene M. Tumiel doctoral candidate in the UB Department of Social and Preventive Medicine, compared rates among Hispanic subgroups.

"We found huge differences between groups of Hispanics," said Tumiel. "Mexican-Americans tended to be the least educated and the poorest, but they had the best birth outcomes. Puerto Ricans were better off than Mexican-Americans, but their birth outcomes were worse. Cubans had better socioeconomic profiles than other Hispanic subgroups, but they had worse outcomes.

"These results show us that physicians and health-care providers of Hispanics need to be aware of ethnic differences if they want to provide the best possible care and improve outcomes," she said. "For example, a physician who was aware of these differences would know that a Puerto-Rican woman who comes to his office for the first time in the third trimester is at greater risk than a third-trimester Mexican-American expectant mother."

Tumiel said the support system within each ethnic group may account for some of the differences and merits closer research.

"Differences in birth outcomes among various ethnic groups has been an issue for years, and we are not getting closer to finding out why," she said. "We need to know why there are differences."

The study of IUD use in China, which accounts for 70 percent of IUD use worldwide, showed that while side effects and failure rates were higher than expected, the overwhelming majority of women in the study had no pregnancies or serious side effects.

Tiejian Wu, a doctoral candidate in the UB Department of Social and Preventive Medicine, along with Germaine Buck, Ph.D., associate professor of social and preventive medicine, reviewed three years of data from 1,912 first-time IUD users who participated in the Fertility and Contraception Survey in Jilin Province in 1988.

Results showed that about 12 percent of women experienced either excessive bleeding, irregular menstruation or abdominal pain. Failure rates, including pregnancy, were 5 percent after the first year, 9 percent after the second year and 12 percent after the third.

About 28 percent of the women had stopped using their IUD after three years, but not primarily because of serious side effects, Buck said. The three reasons cited most often for discontinuance were pregnancy, an expelled IUD and the desire to use another contraceptive method, she noted.

Buck said that along with providing data on the effect of contraception on the health of these women, the findings highlight the importance of following women in such investigations over several years. Failure rates more than doubled between the first and third years, she noted.