Maternal and Child Health Disparities among Native American Women in Oklahoma: A Secondary Analysis of Health Behaviors, Prior Well-Being, and Adverse Pregnancy Outcomes, 2004-2011

摘要

Utilizing data from the Oklahoma Department of Health Pregnancy Risk Assessment Monitoring System (PRAMS) for the years 2004 through 2011, this study examines racial and ethnic differences in unhealthy maternal behaviors and the consequences of those actions on the health of both mother and child. The maternal behavior variables include smoking cigarettes, drinking alcohol, multivitamin use, and prenatal care utilization. The maternal health variables include gestational diabetes and hypertension. The labor and delivery outcome variables include placental issues, premature rupture of membranes (PROM), low birth weight, and child placement in an intensive care unit. This researcher hypothesized that minorities would engage in risky and unhealthy behaviors while pregnant more often than whites due to social disadvantages in the economic and educational realms. Furthermore, minorities would be more likely than whites to have unfavorable outcomes regarding labor, delivery, and health of the child due to lower socioeconomic status, poor maternal health, and underutilization of preventative care. The researcher finds that minority women seem to adhere to proper maternal health recommendations associated with personal choice, including smoking and drinking, though disparities are evident when compared to whites regarding behaviors associated with socioeconomic status, including prenatal care utilization and multivitamin use. African American women are more likely than whites to experience premature rupture of the membranes, have an underweight baby, and to place their baby in ICU, though less likely to experience placental issues. Native American women are less likely than whites to experience premature rupture of the membranes, have an underweight baby, and to place their baby in ICU, but more likely to experience placental issues. As expected, substantial changes have occurred in the maternal health and well-being of Oklahoma mothers over the course of the two PRAMS data collection phases.