Asian Indian Women Research Articles

Physical activity, acculturation, and immigrant status of Asian Indian women living in the United States

Physical activity, acculturation, and immigrant status of Asian Indian women living in the United States

Anti-Mullerian Hormone (AMH) and Age – An Indian laboratory retrospective analysis

Introduction: Anti-Mullerian Hormone (AMH) is considered to be a sensitive biological indicator of the ovarian reserve among women. Produced by the granulosa cells in the ovary, AMH is also considered to be a good biochemical marker to time menopause, apart from being monitored during treatment of certain ovarian tumors. Our retrospective report is an attempt to study AMH levels across different age-groups between 18 – 50 years of age and present age-related changes in levels.
 Methods: Serum AMH estimation was done in a total of 219,227 Asian Indian women using the chemiluminescent immunoassay technology.
 Results: Our analysis of different age-groups with AMH levels detected a declining trend and a significant drop in levels was recorded between ages 19 – 20 years and 35 – 36 years of age at p<0.05.
 Conclusion: Our report is an attempt to present age-effect on AMH levels in a pan-India cohort of Asian Indian women and analysis detected a negative correlation between age and AMH levels.

Insulin resistance and hyperandrogenemia independently predict nonalcoholic fatty liver disease in women with polycystic ovary syndrome

AimsTo find the prevalence and predictors of nonalcoholic fatty liver disease (NAFLD) in Asian Indian polycystic ovary syndrome (PCOS) women. Materials and methodsThis is a prospective, cross-sectional study conducted at a tertiary care hospital from South India. Sixty women fulfilling the Rotterdam (2003) criteria for PCOS were recruited for the study. All participants were evaluated with ultrasound abdomen for fatty liver and additional biochemical investigations including fasting plasma glucose, postprandial plasma glucose, serum insulin, lipid profile and liver function tests. ResultsThe mean age of the study population was 24.06 ± 5.9 (range: 15–39) years. Oligomenorrhea, hirsutism and acne were present in 58 (96.7%), 37 (61.7%) and 33 (55%) women. Mean BMI of the study population was 29.5 ± 5.28 (range: 19.95 to 45.44) kg/m2. Fifty (83.3%) women were obese (BMI: ≥ 25 kg/m2). Twenty-three (38.3%) women with PCOS had NAFLD. Three women each had isolated elevation of alanine transaminase (ALT) and aspartate transaminases (AST) whereas three women had elevation of both. All women with elevated transaminases had NAFLD. By univariate analysis, factors associated with NAFLD were serum total cholesterol, serum insulin, HOMA-IR, hyperandrogenism, ALT and AST. On multiple regression analysis using linear regression, HOMA-IR and hyperandrogenemia were the only significant predictors of NAFLD. ConclusionOur study reports NAFLD in more than one third of Asian Indian women with PCOS. In addition to insulin resistance (HOMA-IR), hyperandrogenemia is an independent predictor of NAFLD in women with PCOS.

Prediction of Gestational Diabetes from First Trimester Serum Adiponectin Levels in Indian Women.

Introduction:The prediction of gestational diabetes mellitus (GDM) by serum adiponectin levels has shown promise in Western literature. This study looks at the first trimester serum adiponectin levels as a predictor of gestational diabetes in Indian women.Material and Methods:A total of 450 pregnant women were screened at 11-- 13 weeks of gestation and serum samples were stored. All the women underwent an oral glucose tolerance test to diagnose GDM by International Association of Diabetes and Pregnancy study Group criteria at 24-- 28 weeks of gestation. Amongst these, 45 women who had developed GDM were compared with 45 controls. The first trimester serum adiponectin levels were compared between the two groups.Results:Mean first trimester adiponectin in GDM and non-GDM group was 7.21 ± 2.49 μg/ml and 12.20 ± 2.91 μg/ml, respectively (P < 0.001). Logistic regression revealed that low adiponectin was the strongest independent risk factor followed by body mass index and HbA1c. Receiver operating characteristic curve revealed that a cut-off value of adiponectin of 9.10 μg/ml in the first trimester was associated with a sensitivity of 100% and specificity of 95.6% in predicting GDM.Conclusions:This is the first study from India which has studied the prediction of GDM by first trimester adiponectin levels. First trimester serum adiponectin may be a strong predictor of GDM in Asian Indian women.

Female adiposity and time-to-pregnancy: a multiethnic prospective cohort

Are higher overall and central adiposity associated with reduced fecundability, measured by time-to-pregnancy (TTP), in Asian women? Higher overall adiposity, but not central adiposity, was associated with longer TTP in Asian women. High body mass index (BMI) has been associated with a longer TTP, although the associations of body composition and distribution with TTP are less clear. There are no previous studies of TTP in Asian women, who have a relatively higher percentage of body fat and abdominal fat at relatively lower BMI. Prospective preconception cohort using data from 477 Asian (Chinese, Malay and Indian) women who were planning to conceive and enrolled in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) study, 2015-2017. Women's mean age was 30.7 years. Overall adiposity was assessed by BMI, sum of 4-site skinfold thicknesses (SFT) and total body fat percentage (TBF%, measured using air displacement plethysmography); central adiposity was assessed by waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and A body Shape Index (ABSI). Pregnancy occurring within one year from recruitment was ascertained by ultrasonography. Those who did not conceive within one year of recruitment, were lost to follow-up, or initiated fertility treatment were censored. TTP was measured in cycles. Discrete-time proportional hazards models were used to estimate the fecundability ratio (FR) and 95% confidence interval (CI) for each anthropometric measure in association with fecundability, adjusting for confounders. Compared to women with a normal BMI of 18.5-22.9 kg/m2, women with higher BMI of 23-27.4 and ≥27.5 kg/m2 showed lower FR of 0.66 (95% CI 0.45, 0.97) and 0.53 (0.31, 0.89), respectively. Compared to women in the lowest quartile of SFT (25-52.9 mm), those in the highest quartile of ≥90.1 mm showed lower FR of 0.58 (95% CI 0.36, 0.95). Compared to women in the lowest quartile of TBF% (13.6-27.2%), those in the upper two quartiles of 33.0-39.7% and ≥39.8% showed lower FR of 0.56 (95% CI 0.32, 0.98) and 0.43 (0.24, 0.80), respectively. Association of high BMI with reduced fecundability was particularly evident among nulliparous women. Measures of central adiposity (WC, WHR, WHtR, ABSI) were not associated with fecundability. Small sample size could restrict power of analysis.The analysis was confined to planned pregnancies, which could limit generalizability of findings to non-planned pregnancies, estimated at around 44% in Singapore. Information on the date of last menstrual period for each month was not available, hence the accuracy of self-reported menstrual cycle length could not be validated, potentially introducing error into TTP estimation. Measures of exposures and covariates such as cycle length were not performed repeatedly over time; cycle length might have changed during the period before getting pregnant. Other than using BMI as the surrogate measure of body fat, we provide additional evidence showing that higher amounts of subcutaneous fat that based on the measure of SFT at the sites of biceps, triceps, suprailiac and subscapular, and TBF% are associated with longer TTP. Achieving optimal weight and reducing total percentage body fat may be a potential intervention target to improve female fertility. The null results observed between central adiposity and TTP requires confirmation in further studies. This research is supported by Singapore National Research Foundation under its Translational and Clinical Research Flagship Programme and administered by the Singapore Ministry of Health's National Medical Research Council, (NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014). Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore. Y.S.C., K.M.G., F.Y. and Y.S.L. have received reimbursement to speak at conferences sponsored by companies selling nutritional products. Y.S.C., K.M.G. and S.Y.C. are part of an academic consortium that has received research funding from Abbott, Nutrition, Nestle and Danone. Other authors declared no conflicts of interest. N/A.

Risk of Cesarean Delivery among Nulliparous Asian-Indian Women with Term Singleton Pregnancies.

Asian-Indian women are a growing population in the United States, but little data exist about their risk of cesarean delivery (CD). We characterize the odds of CD among Asian-Indian women and determine whether neonatal birth weight modifies this relationship. This is a retrospective cohort study using an administrative perinatal database from California. We identified 1,029,940 nulliparous women with live, singleton, nonanomalous deliveries between 37 and 42 completed weeks of gestation. We performed multivariable logistic regression analyses to determine if Asian-Indian women were more likely to deliver by CD, compared with white non-Hispanic women, adjusting for sociodemographic and clinical variables. We explored if birth weight was an effect modifier, testing the interaction term's significance using Wald's test, and performed multivariable logistic regressions stratified by birth weight category. Asian-Indian women comprised 2.0% of the cohort. Compared with white non-Hispanic women, Asian-Indian women had an adjusted odds of 1.41 (95% confidence interval: 1.36-1.46) for CD. However, we noted effect modification of birth weight on the odds of CD by race/ethnicity (p < 0.001). Among all birth weight categories exceeding 3,000 g, Asian-Indian women had higher odds of CD than white non-Hispanic women. Asian-Indian women are at greater risk of CD than white non-Hispanic women when birthweight exceeds 3,000 g.

A National Profile of Functional Limitations Among Asian Indians, Chinese, and Filipinos.

Asian Americans are the fastest-growing minority group in the United States, yet little is known about their functional mobility. To overcome such a gap, this study examined the association between demographic/economic characteristics and functional limitations for middle-aged and older Asian Indians, Chinese, and Filipinos. This study utilized microdata from the National Health Interview Survey pooled sample (2010-2016 IPUMS NHIS with a sample size of 6,767 Asians). Logit regressions were used to examine factors associated with functional limitations. Measures include age, gender, currently married, education (categorized as less than high school, high school, some college, college, advanced degree), birth and citizenship status, household income, home ownership, types of health insurance (e.g., Medicaid, Medicare, private), and geographic region (i.e., Northeast, Midwest, South, and West). Chinese (odds ratio [OR] 0.57, p < .01) and Filipinos (OR 0.74, p < .05) had lower odds for any functional limitations relative to Asian Indians. Currently married and individuals with a higher income were also associated with reduced odds for limitations in the overall analysis. As for the subgroup analysis, there was a positive association between age and the presence of any functional limitations for Asian Indians (OR 1.05, p < .01), Chinese (OR 1.08, p < .01), and Filipinos (OR 1.03, p < .01). In terms of gender, Asian Indian men were less likely (OR 0.51, p < .01), whereas Filipino men were more likely to have limitations (OR 1.09, p < .05). Asian Indians appeared to have a poorer health profile for limitations in dressing, eating, walking, or working when compared with Chinese and Filipinos. A pronounced difference at older ages was also apparent for Asian Indians by gender and the likelihood of having any limitations increased much faster for Asian Indian women. For Chinese, there was a dramatic increase in functional limitations after age 75 (particularly for women) and the predicted probability for this subgroup approximated 20%. For Filipinos, men were more likely to have limitations. These findings raise interesting questions about the on-set of disability by age and gender for Asian subgroups.

Confirmatory Factor Analysis and Psychometric Properties of the Multidimensional Acculturative Stress Scale

ObjectiveThe aim of this study was to examine the psychometric properties of the Multidimensional Acculturative Stress Scale (MASS) when used to examine the stressors faced by senior Asian Indian women immigrants in Australia.MethodData collected from a sample of Asian Indian women immigrants residing in Sydney, Australia, were used to examine the psychometric properties of the MASS using confirmatory factor analysis.ResultsA total of 203 Indian women immigrants with an average age of 66.11-years [standard deviation (SD) ± 9.60; range 50–90) participated in the study. The majority of the participants were born in India (n = 142; 70%) and their length of stay in Australia was between 1-month and 42-years. The original 24‐item, five‐factor MASS structure was confirmed, and the model showed a good fit to the data: comparative fit index = 0.93; root mean square error of approximation = 0.06; and standardised root mean square residual = 0.08. The Cronbach's alpha coefficients for the five subscales ranged from 0.80 to 0.93 and was 0.91 for the overall scale demonstrating high internal consistency.ConclusionsThe findings confirm the factor structure and reliability of the MASS for assessing acculturative stress among female Asian Indian immigrants. However, scale development is an iterative process and further testing in other contexts is recommended.

Lower vitamin D levels are associated with higher blood glucose levels in Asian Indian women with pre-diabetes: a population-based cross-sectional study in North India

BackgroundAsian Indian women are predisposed to develop obesity, metabolic syndrome and vitamin D deficiency. Relationship of vitamin D deficiency with blood glucose levels has not been explored in Asian Indian...

The Status of Public Sector Pay Equity for Women of Color in the United States

Research by Reese and Warner and Llorens, Wenger, and Kellough assesses the relative pay of women in the United States. However, research on the relative pay of women of color remains scant. What kinds of factors predict relative pay for women of color, and are they the same as for White women? The author utilizes ordinary least squares (OLS) regression on an Equal Employment Opportunity Commission (EEOC) panel data set on public sector employment by state to analyze the pay of Black, Hispanic, Asian, and American Indian women relative to men for 2005-2013. The author reaffirms that whether a woman lives in a state that has implemented a major gender pay equity measure is a significant factor determining her relative pay. Furthermore, the intersectional nature of public sector pay for women of color is numerically verified. Women fare better in states where they are descriptively represented in terms of gender and race/ethnic group.

Structural and Functional Changes in Maternal Heart during Pregnancy: An Echocardiographic Study

Abstract Background Pregnancy is associated with profound physiologic alterations in the maternal cardiovascular system. This study aimed to investigate maternal cardiac performance during normal pregnancy by two-dimensional echocardiography parameters and various functional and structural alterations. Methods This was a cross-sectional study of 100 normal pregnant women who attended the antenatal clinic, and all participants had clinical history, physical examination, and 12-lead electrocardiogram. Two-dimensional, M-mode, and Doppler echocardiography was done. Echocardiographic parameters were compared with normal age-matched controls from previously published studies. Results The mean age of the study group was 23.35 ± 3.05 years, mean systolic blood pressure was 110.5 ± 8.69 mm Hg, and mean diastolic blood pressure was 71.6 ± 6.77 mm Hg. There was an increase in left atrial (LA) diameter, left ventricular end diastolic diameter, and interventricular septum (IVS) thickness as gestational age advanced. There was a gradual decrease in E-wave velocity, and E/A ratio increased during the second trimester and decreased during the third trimester. The E-wave deceleration time increased with gestational age There was no statistically significant difference between IVS thickness and E/A ratio (p = 1.000). Conclusion Cardiac chamber dimensions, LV wall thickness, and LA size, most indices of systolic function although within normal range, were significantly higher in pregnant Asian Indian women than in the controls. This study shows that the subtle reduction in myocardial compliance appears as an adaptive response to changes of preload, afterload, and LV geometry.

Asian Indian Women: Domestic Violence, Mental Health, and Sites of Resilience

ABSTRACTCulture is foundational to human experiences. As such, different cultural contexts and systems create different realities and lived experiences. Psychological knowledge and experiences within this context are then subject to socio-cultural systems, historical events, the distribution of economic and political power, and privileged positions of people within the system. This article highlights Asian Indian women’s lived experiences with domestic violence and their ways of healing. In particular, we present personal, political, social, and cultural factors that contribute to vulnerability and resilience in Indian women both in India and within the diaspora and note the role of community as an important indigenous source of healing.

Barriers and Motives to PA in South Asian Indian Immigrant Women.

The high prevalence of chronic illnesses in South Asian Indian immigrant women underscores the need for identifying factors that could influence their PA. The purpose of this qualitative study was to examine the perspectives of South Asian Indian immigrant women related to barriers to and motives for lifestyle PA within the PA Framework for South Asian Indian Immigrants. Forty women participated in focus groups that were conducted in English and Hindi. Focus group questions were open-ended and semistructured. Transcribed and de-identified audiotaped sessions were coded and analyzed using Atlas.ti software. Role expectation was a core theme for barriers with four subthemes: lack of time, loss of interest, diminished social support, and environmental constraints. Self-motivation was a core theme for motives with three subthemes: optimal physical and psychological health, emphasis on external beauty, and strong social support. Future PA interventions need to target these culturally sensitive factors.

Maternal Birthplace is Associated with Low Birth Weight Within Racial/Ethnic Groups.

Introduction While disparities in low birth weight (LBW) incidence by racial/ethnic group are well known, differences in LBW incidence by maternal birthplace within racial/ethnic groups, and particularly, differences after adjustment for pregnancy complications, are less clear. Methods We conducted a population-based study of LBW using 113,760 singleton, live birth records from King County, Washington (2008-2012), a region in the Pacific Northwest with a large immigrant population. Study participants were Asian, non-Hispanic black, Hispanic, Native Hawaiian/Other Pacific Islander (NHOPI), and non-Hispanic white women. Using multivariable logistic regression models, we calculated odds ratios (ORs) and 95% confidence intervals (CIs) to estimate relative risk of LBW (<2500g) related to maternal race/ethnicity and birthplace (defined by the Millennium Development Goals Regional Groupings). Results Compared with non-Hispanic white women, non-Hispanic black, Asian Indian, Filipino, Japanese, and Vietnamese women had 1.57-2.23-fold higher, statistically significant, risk of having a LBW infant, and NHOPI and Mexican women had 1.30-1.33-fold, statistically significant, higher risk. LBW risk was lower for Asian women from Eastern Asia (OR 0.68, 95% CI 0.55-0.85), non-Hispanic black women from Sub-Saharan Africa (OR 0.58, 95% CI 0.47-0.73), and non-Hispanic white women from other developed countries (OR 0.83, 95% CI 0.69-1.00), as compared with their US-born racial/ethnic counterparts. Results were, in general, similar after adjustment for pregnancy complications. Conclusions Compared with mostother racial/ethnic groups, non-Hispanic whites had lower risk of LBW. Foreign-born women had lower risk of LBW compared with their US-born counterpartsin the majority of racial/ethnic groups. Pregnancy complications had minimal effect on the associations.

Elevated glycated hemoglobin predicts macrosomia among Asian Indian pregnant women (WINGS-9).

Aim:The aim of this study was to determine the optimal glycated hemoglobin (HbA1c) cut point for diagnosis of gestational diabetes mellitus (GDM) and to evaluate the usefulness of HbA1c as a prognostic indicator for adverse pregnancy outcomes.Methods:HbA1c estimations were carried out in 1459 pregnant women attending antenatal care centers in urban and rural Tamil Nadu in South India. An oral glucose tolerance test was carried out using 75 g anhydrous glucose, and GDM was diagnosed using the International Association of the Diabetes and Pregnancy Study Groups criteria.Results:GDM was diagnosed in 195 women. Receiver operating curves showed a HbA1c cut point of ≥ 5.0% (≥31 mmol/mol) have a sensitivity of 66.2% and specificity of 56.2% for identifying GDM (area under the curve 0.679, confidence interval [CI]: 0.655–0.703). Women with HbA1c ≥ 5.0% (≥31 mmol/mol) were significantly older and had higher body mass index, greater history of previous GDM, and a higher prevalence of macrosomia compared to women with HbA1c < 5.0% (<31 mmol/mol). The adjusted odds ratio for macrosomia in those with HbA1c ≥ 5.0% (≥31 mmol/mol) was 1.92 (CI: 1.24–2.97, P = 0.003). However, other pregnancy outcomes were not significantly different.Conclusion:In Asian Indian pregnant women, a HbA1c of 5.0% (31 mmol/mol) or greater is associated with increased risk of macrosomia.

Gestational Weight Gain and Pregnancy Outcomes in Relation to Body Mass Index in Asian Indian Women.

Aim:The aim of the study was to compare the weight gain during pregnancy (using Institute of Medicine guidelines) among Asian Indians across different body mass index (BMI) categories (using World Health Organization Asia Pacific BMI cut points) and to compare the pregnancy outcomes in each of the different BMI categories.Methodology:Retrospective records of 2728 pregnant women attending antenatal clinics and private maternity centers in Chennai, South India, from January 2011 to January 2014 were studied. Pregnancy outcomes were analyzed in relation to BMI and weight gain across different BMI categories.Results:Overweight and obese women who gained more weight during pregnancy were at high risk of delivering macrosomic infants (overweight – odds ratio [OR]: 2.3, 95% confidence interval [CI]: 1.1–5.2, P = 0.02 and obese – OR: 1.6, 95% CI: 1.1–2.4, P = 0.01). In addition, obese women who gained more weight were also at high risk of preterm labor (OR: 2.1, 95% CI: 1.1–3.8; P = 0.01), cesarean section (OR: 1.9, 95% CI: 1.4–2.5; P < 0.001), and preeclampsia (OR: 2.8, 95% CI: 1.1–7.2, P = 0.03). Normal weight and overweight women who gained less weight had a protective effect from cesarean section and macrosomia.Conclusions:Overweight/obese women who gained more weight than recommended are at a high risk of developing adverse pregnancy outcomes. Normal and overweight women who gained weight less than recommended have low risk for cesarean section and macrosomia. However, they have a higher (statistically insignificant) risk for low birth weight and preterm birth. This highlights the need for gaining adequate weight during pregnancy.

Differential Gene Expression Pattern in Osteoclast Precursor Cells of Indian Postmenopausal Women with and Without Osteoporosis: A Microarray Based Study

Background: Osteoporosis is a multifactorial disease with strong genetic and epigenetic component. In spite of enormous candidate gene association studies, the etiology and molecular mechanism of disease is not fully known. For identification of new markers of osteoporosis which could be vital in diagnosis and prognosis of disease, genome-wide microarray expression approach was employed.Methods: Osteoclast precursor cells were sorted from circulating monocytes of osteoporotic and nonosteoporotic post menopausal females with similar life-style and year after menopause. Following microarray experimentation, gene enrichment analysis was performed on significant DEGs using Database for Annotation, Visualization and Integrated Discovery (DAVID) tool. Top 10 novel genes were further used for construction of protein-protein interaction network using Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database. To validate microarray gene expression pattern, Real time-PCR was performed.Results: A total of 269 genes were found to be differentially expressed between disease and normal groups, of which 138 were observed to be up regulated and 131 down regulated. Furthermore, novel LHX1 gene was observed to be up regulated and its interaction with BMP4 protein was observed. Three known genes for osteoclastogenesis (viz., CX3CL1, ACP5 and CSF1) were found to be up- regulated. Similar pattern of gene expression have been obtained using RT-PCR.Conclusion: Significant enrichment of PI3K-Akt and TGF-s signaling pathways involving DEGs was found in postmenopausal Asian Indian women. Moreover, up regulated LHX1 gene was discovered as novel gene which may have a role in pathogenesis of osteoporosis and can be used for diagnosis and prognosis along with known osteoporotic markers.

Pregnancy outcome of gestational diabetes mellitus using a structured model of care : WINGS project (WINGS-10).

To evaluate the impact of a structured model of care (MOC) prepared for resource-constrained settings, on the pregnancy outcomes of Asian Indian women with gestational diabetes mellitus (GDM). Pregnant women were screened under the Women in India with GDM Strategy (WINGS) MOC for GDM using the International Association of Diabetes and Pregnancy Study Groups criteria. Women with GDM went through a structured MOC that included medical nutrition therapy (MNT), regular physical activity (PA); and insulin when indicated. Fasting blood glucose and post-prandial blood sugar were monitored every 2 weeks. The pregnancy outcomes of women with GDM who underwent the MOC were compared with those without GDM. Under the MOC, 212 women with GDM were followed through pregnancy, of whom 33 (15.6%) required insulin and 179 (84.4%) were managed with MNT and PA. The maternal and neonatal outcomes of women with GDM were similar to the non-GDM women: there were no significant differences in pregnancy complications such as cesarean section, macrosomia, pre-eclampsia, oligo/polyhydramnios, preterm delivery, neonatal death, fetal distress, hyperbilirubinemia and low birthweight. Implementation of a structured MOC for women with GDM helped achieve pregnancy outcomes similar to those without GDM.

An exploration of Asian Indian women's perception of pain, coping and treatment

An exploration of Asian Indian women's perception of pain, coping and treatment

Substance use, gender, and generation status among Asian Indians in the United States

ABSTRACTThis study examined substance use (cigarette, alcohol, and illicit drug) among first- and second-generation Asian Indian women and men (n = 1,209; ages 18–34) living in the United States. Participants reported low rates of substance use compared to national averages. First-generation participants reported lower rates of substance use. Men were more likely to have used alcohol and tried cigarettes. Within the first generation, gender differences were only significant for alcohol, but within the second generation, gender differences were significant for all three substances. The findings support the resiliency of immigrants and highlight gender differences that occur among second-generation participants.