Telomere Length and Preterm Birth in Pregnant Mexican-Origin Women.

OBJECTIVES: Despite the obstacles of limited education and employment opportunities-and the stress associated with immigration and pregnancy-Mexican immigrant women have low rates of preterm birth (PTB) compared to the US national average for all races and ethnicities. Stressors during pregnancy, and stressors associated with acculturation, may accelerate cellular aging manifested by shortened telomere length (TL) in pregnant women. Our objectives were to: (1) determine whether women with PTBs had shorter telomere lengths compared to women who had full term births; (2) assess the association of acculturation with TL and PTB. METHODS: This prospective pilot study collected data from 100 self-identified Mexican-origin pregnant women. Survey data included self-administered sociodemographic and acculturation measures and was collected from participants via paper and pen, while biologic data was collected via a single blood draw during a regularly scheduled prenatal visit between 26 and 36 weeks gestation. PTB data was collected from the participant's medical record after delivery. RESULTS: TL was significantly associated with PTB; the median TL of the women with PTB was less than the median TL for the full sample (p = 0.02). Based on regression analysis for PTB vs acculturation, we found no significant associations between acculturation and PTB or TL. CONCLUSIONS FOR PRACTICE: This study provides important evidence of the association between shortened maternal TL and adverse birth outcomes. By linking social, clinical and biologic data, we can enhance our understanding of social determinants that may affect racial and ethnic disparities in preterm birth.

Religiosity, Acculturation, and Preterm Birth in Mexican-Origin Women: A Pilot Study.

INTRODUCTION: Explanations for racial disparities in preterm birth (PTB) are elusive, especially when comparing high rates in some racial groups with low rates in Mexican-immigrant women. The purpose of this study was to examine potential protective factors against PTB such as religiosity and acculturation. METHODS: This study was a prospective investigation of Mexican- and U.S.-born pregnant women. Women were recruited from a low-income-serving prenatal clinic in Texas. Survey instruments included socioeconomic variables, acculturation, and religiosity/spirituality (R/S). Logistic regression was used to examine the associations between acculturation, religiosity, and PTB. Because of the low prevalence of PTB in our sample, we were not able to adjust for confounding characteristics. RESULTS: Ninety-one low-income women, mostly Mexican immigrants, participated in the study. PTB in our sample was lower than the national average in the United States (5.5% vs. 9.9%) and was positively but moderately associated with high R/S. R/S scores were high, particularly for frequency of attendance, prayer, and religious coping. Women with lower acculturation had higher scores on the religiosity measures. CONCLUSION: Further research is needed with a larger sample to include other ethnic and racial minorities to more fully understand the relationships between acculturation, religiosity, and PTB.

Acculturation in Mexican immigrants: a concept analysis.

The concept of acculturation in Mexican immigrants was analyzed using the concept analysis technique developed by Walker and Avant. The related concepts for acculturation are assimilation, separation, and marginalization. The defining attributes identified for acculturation are original cultural identity, exposure to a culture different from one's own, and changes in the behavioral, affective, and/or cognitive domains of one's functioning after exposure to a new culture. An antecedent for acculturation is that identification with one's culture of origin must be well established. Another antecedent is the willingness to modify one's original cultural identity. Transition is identified as a consequence of acculturation. Acculturation is a complex, multifaceted concept and cannot be adequately captured by measures that use language preference alone. Other factors such as social class, employment, education, and income should also be considered when acculturation is a factor in nursing practice and research.

Positive pregnancy outcomes in Mexican immigrants: what can we learn?

OBJECTIVE: To provide an integrated review of the literature of potential explanations for better than expected pregnancy outcomes in Mexican immigrants, focusing on socioeconomics, social support, desirability of pregnancy, nutrition, substance use, religion, acculturation, and prenatal care. DATA SOURCES: Computerized searches of MEDLINE and CINAHL databases, as well as reference lists from published articles on low birth weight and prematurity in immigrants and acculturation in immigrants from January 1989 to December 2002. Search terms were Mexican immigrant women, childbearing, and pregnancy outcome, and only English-language articles were reviewed. STUDY SELECTION: Literature was selected from refereed publications in the areas of nursing, medicine, public health, family, and sociology. DATA EXTRACTION: Data were extracted using keywords pertinent to pregnancy outcome in Mexican immigrants. DATA SYNTHESIS: Despite having many of the risk factors for poor pregnancy outcomes, Mexican immigrants have superior birth outcomes when compared to U.S.-born women. Social support, familism, healthy diet, limited use of cigarettes and alcohol, and religion may play a role in improved outcomes. The superior outcomes diminish with the process of acculturation as the individual adapts to her new culture. CONCLUSIONS: Low birth weight and prematurity are public health concerns in the United States. Through further study of the factors that lead to superior birth outcomes among Mexican immigrant women, rates of low birth weight and prematurity in the United States may be reduced.