Disparities in Adverse Perinatal Outcomes Among Pacific Islanders in the Commonwealth of the Northern Mariana Islands

Rica Dela Cruz,Julia E Heck,Haley L Cash,Jeanolivia Grant

doi:10.5888/pcd15.170385

Abstract

IntroductionAlthough other studies have found evidence for perinatal health disparities among Pacific Islanders in other regions, no studies have evaluated racial/ethnic disparities in adverse perinatal health outcomes in the small US island territory of the Commonwealth of the Northern Mariana Islands (CNMI).MethodsWe used retrospective cohort data on 8,427 singleton births from 2007 to 2014 at the Commonwealth Healthcare Corporation (CHCC), the only hospital in the CNMI. We used multivariate logistic regression to estimate risk for preterm birth (<37 weeks) and macrosomia (>4,000 g) among the racial/ethnic groups in the CNMI.ResultsIndigenous CNMI mothers (Chamorros and Carolinians, hereinafter Chamorro/Carolinian) and other Pacific Islander mothers were significantly more likely to have a preterm birth than Chinese mothers (adjusted odds ratio [AOR] = 2.7; 95% confidence interval [CI], 2.0–3.6 for Chamorro/Carolinians and AOR = 2.9; 95% CI, 2.1–4.1 for other Pacific Islanders). Additionally, Chamorro/Carolinian mothers and other Pacific Islander mothers were also significantly more likely to deliver babies with macrosomia (AOR = 2.4; 95% CI, 1.7–3.5 and 2.3; 95% CI 1.4–3.6 respectively) than Filipino mothers.ConclusionAlthough underlying causes for these disparities are still unknown, these findings add to the limited knowledge on maternal and neonatal health among Pacific Islanders and provide support for further research and intervention development to aid in reducing racial/ethnic disparities of perinatal health in the CNMI.

Highlights

Other studies have found evidence for perinatal health disparities among Pacific Islanders in other regions, no studies have evaluated racial/ethnic disparities in adverse perinatal health outcomes in the small US island territory of the Commonwealth of the Northern Mariana Islands (CNMI)
Carolinian mothers and other Pacific Islander mothers were significantly more likely to deliver babies with macrosomia (AOR = 2.4; 95% confidence interval (CI), 1.7–3.5 and 2.3; 95% CI 1.4–3.6 respectively) than Filipino mothers
Conclusion underlying causes for these disparities are still unknown, these findings add to the limited knowledge on maternal and neonatal health among Pacific Islanders and provide support for further research and intervention development to aid in reducing racial/ethnic disparities of perinatal health in the CNMI

Summary

Introduction

Other studies have found evidence for perinatal health disparities among Pacific Islanders in other regions, no studies have evaluated racial/ethnic disparities in adverse perinatal health outcomes in the small US island territory of the Commonwealth of the Northern Mariana Islands (CNMI). The CNMI is a chain of 14 islands with almost all inhabitants residing on 3 of the islands: Saipan, Tinian, and Rota These islands have a total population of approximately 54,000 and are home to diverse races/ethnicities, which include the indigenous CNMI Pacific Islanders (Chamorros and Carolinians), other Pacific Islanders (Palauans, Marshallese, Chuukese, Pohnpeians, Kosraeans, Yapese, Samoans, and Hawaiians), Asians (Filipinos, Chinese, Japanese, Koreans, Thais, Indians, Bangladeshi, and Nepalese), and other races and nationalities (American whites, African Americans, and Russians) [1]. Studies conducted in other island jurisdictions show that indigenous Pacific Islanders overall appear to have poorer health outcomes than non-Pacific Islander populations, including increased risk of chronic diseases

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