583 - Maternal Characteristics and Birth Outcomes for Hispanic Families in a Rural State

Poster Number: 583
Publication Number: 583.241

Carolyn Ahlers-Schmidt, University of Kansas School of Medicine-Wichita, Wichita, KS, United States; Hayrettin Okut, University of Kansas School of Medicine, Wichita, KS, United States; Lisette Jacobson, University of Kansas School of Medicine, Wichita, KS, United States; Ashley Hervey, University of Kansas School of Medicine-Wichita, Wichita, KS, United States; Amanda I. Aguila Gonzalez, University of Kansas School of Medicine, Wichita, KS, United States; David T. Alley, University of Kansas School of Medicine, Valley Center, KS, United States; Macin L. Harvey, University of Kansas School of Medicine, Andover, KS, United States; Alisha A. Sanchez, KU School of Medicine-Wichita, Wichita, KS, United States

Background: In the United States, Hispanic women have the highest fertility rate compared to non-Hispanic black and non-Hispanic white women, yet there is a dearth of literature on the needs and health outcomes among this population. Evidence suggests that despite being socially disadvantaged US Hispanic birth outcomes are better than expected compared to other non-White groups; however, in Kansas the Hispanic infant mortality rate is twice that of non-Hispanic white.

Objective: Evaluate birth outcomes for Hispanic women in a rural Midwestern state to identify key drivers and areas for intervention.

Design/Methods: Vital statistics data, including linked birth and death certificates, for Kansas births between 2005 and 2018 were included. Singleton births to Hispanic women were explored including low birth weight ( < 2500 g), preterm birth ( < 37 weeks gestation) and infant death ( < 1 year). Acculturation was estimated based on mother’s place of birth (US vs non-US) and preferred language (English vs Spanish). Multiple logistic regression model with Firth’s penalized maximum likelihood estimation was used to investigate the relationship between outcome variables and a set of explanatory variables.

Results: Of the 536,446 singleton births in Kansas during the study period, 86,792 were to women who identified as Hispanic. Multivariate models (Table 1) revealed several maternal, behavioral, and infant factors related to preterm birth, low birth weight and infant death. Predictive accuracy for birth outcomes was moderate to strong, with areas under the receiver operating characteristics (ROC) curve as follows: preterm birth=0.716 (95% CI, 0.707-0.724), low birth weight=0.678 (95% CI, 0.668-0.687) and infant death=0.825% (95% CI, 0.791-0.859).Conclusion(s): Maternal factors, such as high acculturation, unmarried, and low socioeconomic status (as indicated by payor and WIC participation), as well as congenital anomalies increased the risk of low birth weight and preterm birth. Behavioral factors, such as tobacco use and timing and adequacy of prenatal care also impacted birth outcomes. Further, birth weight, gestational age, congenital anomalies, and breastfeeding initiation significantly increased the risk for infant death. Increasing access to early prenatal services such as prenatal care and comprehensive education for Hispanic women that address modifiable risk factors is crucial. Differences in access to services based on language, citizenship, socioeconomic status and cultural factors inform intervention programming.
Table 1: Birth Outcomes for Hispanic Women with Singleton Births by Maternal Characteristics