The Influence of Pre-natal Supplement Initiation on Preterm Birth Among Majority Hispanic Women in Los Angeles County: T
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The Influence of Pre-natal Supplement Initiation on Preterm Birth Among Majority Hispanic Women in Los Angeles County: The Role of Nativity Vivian H. Alfonso1 • Ondine von Ehrenstein2 • Gretchen Bandoli1 Beate Ritz1
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Ó Springer Science+Business Media New York 2016
Abstract Objectives Despite being encouraged to take pre-natal supplements, suboptimal micronutrient intake is common in pregnancy, especially among Hispanic women. In this study, we assessed whether initiation and timing of pre-natal vitamin use influences the risk of preterm birth. Methods Women who gave birth to singletons in 2003 in Los Angeles County, California, were enrolled into a population-based case–control study. Focusing on nonHispanic white and Hispanic women, associations between timing of pre-natal supplement use and preterm birth were assessed using logistic regression. Results Among Hispanic mothers, the odds of preterm birth increased the later a woman initiated pre-natal supplement use in pregnancy. The magnitude of this association was larger in US-born compared to foreign-born Hispanic women. Conclusions These findings suggest that nativity may modify the relationship between pre-natal supplement use and preterm birth possibly due to underlying differences in diet composition of Hispanic women by place of birth. Keywords Folic acid Prenatal nutrition Preconception nutrition Preterm birth Nutritional epidemiology Maternal public health
& Vivian H. Alfonso [email protected] 1
Department of Epidemiology, University of California, Los Angeles, Fielding School of Public Health, Box 951772, Los Angeles, CA 90095, USA
2
Department of Community Health Sciences, University of California, Los Angeles, Fielding School of Public Health, Box 951772, Los Angeles, CA 90095, USA
Significance Our results suggest that as many as 66 % of white and 28 % of Hispanic women use supplements before pregnancy. This investigation is important in providing information to better target potential intervention and educational efforts as our findings suggest that initiating pre-natal supplements once pregnancy is identified confers an increased risk of preterm birth, especially for US-born Hispanic women. Given that supplement use is a modifiable behavior, possible interventions should be tailored to this population of women. Such public health strategies may include: educational campaigns to encourage planned pregnancies among Hispanic women of reproductive age; for planned pregnancies, educational campaigns to encourage women to initiate supplements prior to conception; or encouraging prophylactic pre-natal supplementation of all women of child-bearing age.
Introduction Infant health problems related to preterm birth (PTB, \37 completed weeks gestation) are the leading cause of infant death in the United States [8]. While gestational age at birth among preterm births influences the severity of adverse outcomes, prematurity in general is a risk factor for subsequent morbidity, mortality, and long-term health issues [13, 1, 18, 22, 27, 4]. S
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