Farm Work & Preterm Low Birthweight Among Hispanic Women
Farm Work & Preterm Low Birthweight Among Hispanic Women
The most persistent and intractable cause of infant and child mortality and morbidity in the
 US remains preterm and low birthweight deliveries. Pregnant women in the United States
 experience the highest incidence of these complications among developed countries. Even more
 disturbing is the observation that immigrant Hispanic women experience worsening birth
 outcomes the longer they live here, despite increasing access to prenatal care, improved
 socio-economic status and better education. The purpose of this study is to identify the
 potential acculturation-related risk factors for preterm and low birthweight (PTLBW) delivery
 among Hispanic women of varying lengths of US residency. It is hypothesized that changes in
 factors associated with acculturation, such as poor nutritional intake, job stress and
 occupational exposures to pesticides or other hazards, and certain types of genital
 infections, can best explain the worsening of pregnancy outcomes among Hispanic immigrant
 women.
The most persistent and intractable cause of infant and child mortality and morbidity in the
 US remains preterm and low birthweight deliveries. Pregnant women in the US experience the
 highest incidence of these complications among developed countries. Despite many efforts at
 increasing prenatal care, rates of preterm delivery have not substantially changed in the
 last decade. Even more disturbing is the observation that immigrant Hispanic women experience
 worsening birth outcomes the longer they live in the US, despite increasing access to
 prenatal care, improved socio-economic status and better education. (Within five years after
 moving to the US, the odds ratio for preterm low birth weight delivery increases by 1.9, from
 4% to 7%.)

 As migrant women become acculturated to the US, they must be exposed to factors that
 adversely affect pregnancy outcomes. But the known risk factors, such as poverty, lack of
 education, smoking, substance abuse, inadequate pregnancy weight gain, low pre-pregnancy
 weight, high altitude, chronic diseases, primipara, and high parity, explain only a small
 percentage of this change in incidence.

 The prospective study will enroll a cohort of approximately 1500 pregnant Hispanic women
 attending prenatal care services through an OB/GYN group at the San Joaquin General Hospital
 in Stockton, CA. The majority of Hispanic women (67%) receiving prenatal care through this
 group are Mexican immigrants of varying lengths of US residency, and up to 26% of them are
 involved in farm labor and/or other types of manual labor. Eighteen percent are US-born
 Mexican women. A study of this unique population of Hispanic women of varying lengths of US
 residency, and factors related to occupational risks, acculturation and preterm low birth
 weight deliveries, will provide an excellent opportunity to examine the factors of
 acculturation-based causes of preterm low birthweight (PTLBW).

 The investigators hypothesize that job stress and occupational exposures related to farm work
 can best explain the worsening of pregnancy outcomes among Hispanic women. However, in order
 to ensure an understanding of the mechanism of this increased rate of preterm low birthweight
 within this population, this study will also examine other risk factors that could possibly
 be associated with acculturation and preterm low birthweight. Such factors include changes in
 nutrition intake, and certain types of genital infections such as Bacterial Vaginosis,
 Gonorrhea and Chlamydia.

 The knowledge that emerges will have direct application for designing improved programs for
 the prevention of preterm low birthweight deliveries among Hispanic women. Just as important,
 it will provide insight into the underlying causes of the scandalously high rates throughout
 all US populations.
Pregnant Hispanic women receiving prenatal care services at San Joaquin General Hospital's
 Healthy Beginnings Clinics in Stockton California