Perinatal outcomes among Asian American and Pacific Islander women.

OBJECTIVE: The purpose of this study was to examine perinatal outcomes between Asian American and Pacific Islander subgroups. STUDY DESIGN: This is a retrospective study of all Asian American/Pacific Islander women who were delivered at Stanford University Medical Center from 1998 to 2003. Asian American women were subdivided into the following groups: Indian/Pakistani, Chinese, Filipino, Japanese, Korean, Pacific Islanders (individuals from Tonga, Samoa, Guam, or Polynesia), and Vietnamese. Perinatal outcomes included gestational hypertension/preeclampsia, gestational diabetes mellitus, preterm delivery, cesarean delivery, birthweight <2500 g, and birthweight >4000 g. RESULTS: In the study population of 3779 Asian American women, there were statistically significant differences (P < .01) between most of the outcomes that were examined. Filipina women had the highest risk of gestational hypertension/preeclampsia (adjusted odds ratio, 2.21); Indian/Pakistani women had the highest risk of preterm delivery (adjusted odds ratio, 1.67), gestational diabetes mellitus (adjusted odds ratio, 1.39), and low birthweight at term (adjusted odds ratio, 2.30); and Pacific Islander women had the highest risk of macrosomia (adjusted odds ratio, 3.67). CONCLUSION: Significant differences in perinatal outcomes exist between subgroups of the Asian American and Pacific Islander community. Future research on race/ethnicity and perinatal outcomes should examine heterogeneity among these groups before collapsing these individual subgroups into the larger group "Asian." Individuals should be counseled regarding perinatal risk according to their specific Asian subgroup.

Perinatal complications among different Asian-American subgroups.

OBJECTIVE: This study was undertaken to investigate the differences in perinatal outcomes among Asian American/Pacific Islander (AAPI) women. STUDY DESIGN: A retrospective cohort study of all Japanese, Chinese, and Filipina women who delivered at University of California, San Francisco from 1985 to 2001 examined the incidence of gestational diabetes, preeclampsia, and preterm delivery. RESULTS: Among the 6511 women delivered during the study period, the incidence of preeclampsia was highest among Filipina women (6.8%) compared with the Chinese and Japanese women (4.0% and 3.7%, respectively, P < .001). Gestational diabetes was most common in the Chinese and Filipina women (6.5% and 6.1%, respectively) compared with the Japanese women (3.4%, P = .013). Preterm delivery was also highest among Filipina women both before 37 weeks (12.2%, P < .001) and 34 weeks (4.8%, P = .004). These differences remained statistically significant after controlling for potential confounding variables. CONCLUSION: We found significant differences in rates of preeclampsia, gestational diabetes, and preterm delivery in the Chinese, Japanese, and Filipino subgroups. In studies of race and ethnicity, it is important to examine Asian subgroups separately.

Subclavian vein thrombosis following IVF and ovarian hyperstimulation: a case report.

Thromboembolic phenomena are a serious consequence of assisted reproductive technology. We present a case of upper extremity deep vein thrombosis (DVT) at 7 weeks gestation following ovarian hyperstimulation syndrome (OHSS) and IVF. Three weeks after recovering from OHSS, the patient presented with left neck pain and swelling. Ultrasound revealed a thrombus in the left jugular vein and left subclavian vein. Low molecular weight heparin (LMWH) was initiated with symptom resolution within 1 week. The patient remained on LWMH throughout her pregnancy and delivered at term. A literature review showed 97 published cases of thromboembolism following ovulation induction. A majority of these cases was associated with OHSS and pregnancy and the site of involvement was predominantly in the upper extremity and neck. Infertility physicians and obstetricians should be aware of this complication and keep in mind that it may occur weeks after resolution of OHSS symptoms.