Pregnant Latinas Research Articles

A Behavior Change Model to Improve Vegetable and Fruit Intake Among Low‐income Pregnant Latinas

The primary objective of these analyses was to develop a behavioral change model to improve vegetable and fruit (V&F) intake among pregnant Latinas. Forty‐five in‐depth interviews were conducted with pregnant Latinas living within Hartford. Analyses were conducted to identify and reach convergence on emerging domains and themes. Preliminary results identified 8 domains (Support, Health Outcome Expectancies, V&F access, V&F preferences, V&F knowledge, Behavioral Factors, and Health Status) and one main outcome, increased V&F intake. Each domain had an average of 3 main themes. Support was the primary domain influencing V&F intake through two indirect pathways: V&F knowledge and V&F access. V&F knowledge influenced both V&F preferences and behavioral factors, ultimately affecting V&F intake, while V&F access directly influenced V&F intake. Health outcome expectancies influenced both V&F preferences and behavioral factors, thus affecting V&F intake. Health status linked indirectly to V&F intake by influencing behavioral factors. The key predictor of the support domain was found to be family structure. Preliminary findings strongly suggest family structure is the key predictive factor influencing V&F indirectly through the support pathway. Strategies focused on strengthening family support are necessary for improving V&F intake among low‐income pregnant Latinas. (Funded by NIH/NINR)

Mediators and Moderators of the Effectiveness of a Community Health Worker Intervention That Improved Dietary Outcomes in Pregnant Latino Women.

Pregnancy is an opportune time to initiate diabetes prevention strategies for minority and underserved women, using culturally tailored interventions delivered by community health workers. A community-partnered randomized controlled trial (RCT) with pregnant Latino women resulted in significantly improved vegetable, fiber, added sugar, and total fat consumption compared to a minimal intervention group. However, studying RCT intervention effects alone does not explain the mechanisms by which the intervention was successful or help identify which participants may have benefitted most. To improve the development and targeting of future community health worker interventions for high-risk pregnant women, we examined baseline characteristics (moderators) and potential mechanisms (mediators) associated with these dietary changes. Secondary analysis of data for 220 Latina RCT participants was conducted. A linear regression with effects for intervention group, moderator, and interaction between intervention group and moderator was used to test each hypothesized moderator of dietary changes. Sobel-Goodman mediation test was used to assess mediating effects on dietary outcomes. Results varied by dietary outcome. Improvements in vegetable consumption were greatest for women who reported high spousal support at baseline. Women younger than age 30 were more likely to reduce added sugar consumption than older women. Participants who reported higher baseline perceived control were more likely to reduce fat consumption. No examined mediators were significantly associated with intervention effects. Future interventions with pregnant Latinas may benefit from tailoring dietary goals to consider age, level of spousal support, and perceived control to eat healthy.

Intervention design for increasing fruits and veggies among low‐income pregnant Latinas (624.12)

The primary study objective is to identify a culturally appropriate intervention to increase fruit and vegetable (F&V) intake among low‐income pregnant Latinas. One focus group and 2 small group discussions have been conducted with: (1) Latina prenatal care staff members from a local community based organization (N=5); (2) younger and more acculturated pregnant Latinas (N=2); (3) older and less acculturated pregnant Latinas (N=3). Group discussions lasted from 116 to 165 min. Preliminary content analysis indicates consensus that pregnancy is a “teachable moment” where maternal eating patterns can be influenced due to the benefit it offers the offspring. Also, nutrition education sessions and cooking/taste testing demonstrations (with recipes) should be vital intervention components, thus teaching participants to prepare healthy, tasty dishes. The first two groups favored both group and individual education delivered by community health educators, while those in the latter group favored group education only. Eliciting individual motivation and determination to change were cited as key factors for intervention success. Staff participants felt improving physical and economic access to F&Vs also needed to be a key intervention component, citing various methods including using existing resources (i.e. produce mobile vending units), encouraging community gardens, or providing F&Vs through local NGOs. Preliminary findings suggest that the social‐ecological framework should guide the final intervention design. Grant Funding Source: Supported by NIH‐NINR (Grant #: 1R21NR013970)

Is Depression Associated with Contraceptive Motivations, Intentions, and Use Among a Sample of Low-Income Latinas?

BackgroundLatinas in the United States experience high rates of unintended pregnancy and low rates of contraception use, yet reasons are not completely understood. Depression is common among pregnant and nonpregnant Latinas; its influence on contraceptive motivations, intentions, and use is understudied. ObjectivesWe sought to 1) describe Latinas' contraceptive motivations, intentions, and use; 2) use structural equation modeling to test associations between depression and contraceptive self-efficacy/motivations/intentions/use; and 3) determine whether associations differ by pregnancy status. MethodsThis cross-sectional study included Latinas ages 15 to 45 recruited from an urban Federally Qualified Health Center in Baltimore, Maryland. Structured surveys were used to collect data regarding depressive symptoms measured using the PHQ-9. All other constructs were measured with previously validated questions. Constructs included contraceptive self-efficacy, positive and negative contraceptive motivations (perceived advantages and disadvantages of using contraception), contraceptive intentions to begin or continue contraception use, and contraceptive methods currently used. ResultsAmong pregnant Latinas, depression was associated with negative motivations (β = 0.16; p < .05), negative motivations were associated with intentions (β = −0.22; p < .01), and contraceptive self-efficacy was associated with intentions (β = 0.43; p < .001). Among nonpregnant Latinas, contraceptive self-efficacy was associated with intentions (β = 0.78; p < .001) and intentions were associated with use (β = 0.40; p < .05). ConclusionsAmong pregnant Latinas, negative motivations intervene in the association between depression and contraceptive intentions. For nonpregnant Latinas, intentions intervene in the association between self-efficacy and contraceptive use. This study underscores the importance of depression screening during pregnancy and encourages practitioners to target contraceptive motivations to improve contraceptive use.

Factors associated with clinically significant insomnia among pregnant low-income Latinas.

Poor sleep, common during pregnancy, is associated with negative health risks. The study aimed to identify predictors of clinically significant insomnia among pregnant Latinas. A total of 1289 pregnant Latinas recruited from obstetric clinics completed the Insomnia Severity Index (ISI) and questions about demographics and sleep. Clinically significant insomnia (ISI≥10) was present among 17% of participants. Significant correlates of clinically significant insomnia were higher scores on the Edinburgh Postnatal Depression Scale (EPDS) after removing the sleep item (47% of women with EPDS≥9 and 9% with EPDS<9), completing measures in English (rather than Spanish: 26% versus 13%), and income but not pregnancy week, age, highest education level, or marital status. The highest percentage of clinically significant insomnia (59%) was experienced by women with EPDS≥9 who completed measures in English. The lowest percentage of clinically significant insomnia (6.2%) was experienced by women with EPDS<9 who completed measures in Spanish. In this sample of low-income, mostly Spanish-speaking pregnant Latinas, rates of clinically significant insomnia appear to be higher than rates among nonpregnant Latinas. Rates of clinically significant insomnia are particularly high among Latinas with elevated depressive symptom severity, a known risk for insomnia. Acculturation, as indicated by completing measures in English, may be another risk specific to Latinas, possibly owing to loss of some ethnicity-specific protective factors (e.g., social support, strong family ties, and group identity). It will be important to directly test this explanation in future research.

Dietary Outcomes in a Spanish-Language Randomized Controlled Diabetes Prevention Trial With Pregnant Latinas

We evaluated the effectiveness of a community-based healthy lifestyle intervention in improving dietary behaviors of pregnant Latinas from 2004 to 2006 in Detroit, Michigan. The 11-week, culturally tailored, Spanish-language Healthy Mothers on the Move (MOMs) intervention offered home visits, group classes, related activities, and social support from trained community health workers (CHWs) and peers. Dietary behaviors were measured by food frequency questionnaire. Linear mixed models estimated pre- and post-intervention changes, within and between MOMs intervention and minimal intervention (MI) groups. MOMs (n = 139) and MI (n = 139) participants had similar baseline characteristics and dietary intake. Post-intervention, MOMs participants showed significant improvement in all dietary behaviors, except fruit and fiber consumption. Compared with MI participants, MOMs participants had significantly decreased consumption of added sugar (P = .05), total fat (P < .05), saturated fat (P < .01), percentage of daily calories from saturated fat (P < .001), solid fats and added sugars (P < .001), and had increased vegetable consumption (P < .001). Their increase in fiber consumption (P < .05) was significant relative to MI participants' decrease in fiber intake. We confirmed the hypothesis that a community-planned, CHW-led healthy lifestyle intervention could improve dietary behaviors of low-income Latina women during pregnancy.

Persistent food insecurity is associated with active coping strategies among low‐income pregnant Latinas

The objective of this study was to evaluate the relationship of persistent food insecurity during pregnancy with coping strategies among low income pregnant Latinas (N=92). Persistent food insecurity was assessed using a modified version of the U.S. Household Food Security Scale across two time periods during pregnancy. Coping strategies were assessed using an adapted version (consisting of eleven subscales) of the Brief COPE. Preliminary results showed that persistent food insecurity was associated with higher levels of 4 coping subscales: self‐distraction, planning, acceptance, use of religion. Factor analyses of the 11 subscales suggested three overall coping strategies: active coping, negative emotion coping, and avoidant coping. Findings from unadjusted logistic regression analyses showed that women who experienced persistent food insecurity during pregnancy were 3.5 times more likely to use active coping strategies (consisting of humor, positive reframing, religion, planning, acceptance subscales) than those who experienced intermittent food insecurity or who were food secure. These findings suggest that active coping strategies may be more effective for Latinas experiencing persistent food insecurity during pregnancy than other coping strategies. Funded by Connecticut NIH EXPORT Center of Excellence for Eliminating Health Disparities among Latinos (NIH‐NCMHD Grant # P20MD0017650).

Exploring Perceptions and Experiences of Maternal Depression in Latinas: A Qualitative Study

Understanding how depression is conceptualized is key to designing effective screening and treatment procedures. Of particular concern is maternal depression in Latinas, given the high Latina birthrate. We conducted two focus groups of pregnant Latinas to elicit their perceptions of and experiences with maternal depression. Women reported familiarity with the concept of maternal depression and that their experiences with depression were linked to social support from family and friends. Women also indicated that they felt responsible for coping and recovering from depression independently. How experiences with depression interact with traditional Latino idioms of distress, needs further investigation.

Erratum to: Effect of the Healthy MOMs Lifestyle Intervention on Reducing Depressive Symptoms Among Pregnant Latinas

Erratum to: Effect of the Healthy MOMs Lifestyle Intervention on Reducing Depressive Symptoms Among Pregnant Latinas

Effect of the Healthy MOMs Lifestyle Intervention on Reducing Depressive Symptoms Among Pregnant Latinas

Depression during the prenatal and postpartum periods is associated with poor maternal, perinatal and child outcomes. This study examines the effectiveness of a culturally and linguistically tailored, social support-based, healthy lifestyle intervention led by trained community health workers in reducing depressive symptoms among pregnant and early postpartum Latinas. A sample of 275 pregnant Latinas was randomized to the Healthy MOMs Healthy Lifestyle Intervention (MOMs) or the Healthy Pregnancy Education (control) group. More than one-third of participants were at risk for depression at baseline. MOMs participants were less likely than control group participants to be at risk for depression at follow-up. Between baseline and 6 weeks postpartum, MOMs participants experienced a significant decline in depressive symptoms; control participants experienced a marginally significant decline. For MOMs participants, most of this decline occurred during the pregnancy intervention period, a time when no change occurred for control participants. The change in depressive symptoms during this period was greater among MOMs than control participants ("intervention effect"). From baseline to postpartum, there was a significant intervention effect among non-English-speaking women only. These findings provide evidence that a community-planned, culturally tailored healthy lifestyle intervention led by community health workers can reduce depressive symptoms among pregnant, Spanish-speaking Latinas.

Physical activity and dietary behaviors associated with weight gain and impaired glucose tolerance among pregnant Latinas.

Pregnancy has been proposed as a critical period for the development of subsequent maternal overweight and/or obesity. Excessive gestational weight gain is, in turn, associated with maternal complications such as cesarean delivery, hypertension, preeclampsia, impaired glucose tolerance, and gestational diabetes mellitus. Although there is substantial evidence that targeting at-risk groups for type 2 diabetes prevention is effective if lifestyle changes are made, relatively little attention has been paid to the prevention of excessive gestational weight gain and impaired glucose tolerance during pregnancy. Latinos are the largest minority group in the United States, with the highest birth and immigration rates of any minority group and are disproportionately affected by overweight and obesity. However, due to cultural factors, socioeconomic factors, and language barriers, Latinos have had limited access to public health interventions that promote healthy lifestyles. Therefore, the objective of this article is to review the scientific evidence regarding the association between physical activity, dietary behaviors, and gestational weight gain and impaired glucose tolerance among Latinas. A second objective is to discuss how lifestyle interventions including weight management through diet and exercise could be successful in reducing the risk of excessive gestational weight gain and gestational diabetes mellitus. Finally, recommendations are provided for future lifestyle intervention programs in this population with a focus on translation and dissemination of research findings.

Early life nutrition disparities: where the problem begins?

Empirical evidence continues to accumulate indicating that early life nutrition disparities are likely to explain, at least in part, higher risks for maternal disease (e.g., gestational diabetes) and childhood obesity among ethnic/racial minority groups. Minority women are more likely to be overweight or obese when they become pregnant. This condition may trigger a series of events including excessive weight gain during pregnancy compared with the Institute of Medicine recommendations (1), altered glucose and lipid metabolism, suboptimal infant feeding outcomes, and postpartum weight retention that, when combined, may explain, at least in part, a higher obesity risk among their offspring. This supplement from Advances in Nutrition follows a life cycle approach to first understanding disparities, if any, in prepregnancy BMI, weight gain during pregnancy, gestational diabetes, and infancy/early childhood risk factors for childhood obesity including suboptimal infant feeding practices. Second, each article attempts to provide possible solutions for addressing documented disparities. The collection of 5 review articles that follows this introduction represents an important advance in synthesizing the knowledge in an area that is critical to better understanding how to improve public health in the United States and beyond. Three of these articles focus on maternal outcome disparities before, during, and after pregnancy (2–4), and 2 focus primarily on the infancy/early childhood period (5,6). Whenever possible, the authors of the articles included in this special issue examine the effectiveness of local community programs and federal food assistance programs in reversing health disparities in maternal and infant health. As reported by Siega-Riz (2) in this supplement, minority women are not only more likely to be overweight/obese when becoming pregnant for the first time, but they are also more likely to become pregnant at younger ages and have more children than their white counterparts. Thus, they are also more likely to go through the mother-child obesity cycle (Fig. 1) more times during their reproductive life than white women. Therefore, their increased risk of excessive body fat accumulation, in relation to that of their white counterparts, may also be the result of more “exposures” to the obesity cycle and not only to the weight differentials when becoming pregnant for the first time. Headen et al. (3) confirm in their review that minority women are more likely to experience inadequate weight gain during pregnancy and that there are no disparities with regard to excessive gestational weight in relation to their white counterparts. The authors found that black women were more likely to retain excessive weight postpartum compared with Hispanic and white women. Headen et al. also document that interventions seeking to improve gestational weight gain and postpartum weight retention outcomes have thus far yielded mixed results. A major finding from their review is the lack of studies that explicitly address reasons for racial/ethnic differences in pregnancy-related weight. Studies in this area are urgently needed to develop effective pregnancy-related weight-control interventions among minority women. Chasan-Taber (4) reviewed the literature to determine whether physical activity, diet, and excessive weight gain during pregnancy are associated with impaired glucose tolerance/gestational diabetes among pregnant Latinas. This review provides support for an inverse association between exercise during pregnancy and risk of gestational diabetes among Latinas. Based on limited evidence, it also found support for an association between certain nutrient intakes (fewer saturated fatty acids and energy-dense foods, higher intakes of fiber, and a higher polyunsaturated:saturated fatty acid ratio) and lower risk of abnormal glucose tolerance, independent of gestational 1

Nutrient and food intakes differ among Latina subgroups during pregnancy

To document nutrient and food group serving intakes from food sources among Latina subgroups living in the same geographical area. A cross-sectional study. Nutrient and food group serving intakes were assessed by means of a 24 h recall administered immediately after a prenatal survey. Hartford, CT, USA. A total of 233 low-income pregnant Latinas. For analyses, Latinas were classified into two groups on the basis of self-reported ethnic identity: Puerto Ricans and non-Puerto Rican Latinas. Puerto Rican Latinas were more likely than non-Puerto Rican Latinas to be more acculturated and to consume foods (i.e. processed meat, cheese, soft drinks) and higher levels of nutrients (i.e. fat, SFA, MUFA, trans fatty acids) that have been implicated in the development of chronic diseases. By contrast, non-Puerto Rican Latinas were more likely to consume foods (i.e. fruits, dark green/yellow vegetables, tomatoes, non-starchy vegetables) and higher levels of nutrients (i.e. fibre, vegetable protein, folate, β-carotene) that promote health when compared with Puerto Rican Latinas. Findings suggest that acculturation may play a role in dietary intake. Clinicians and dietitians need to be aware of these differences to encourage healthy eating patterns among more acculturated pregnant Latina clients.

Recent intimate partner violence as a prenatal predictor of maternal depression in the first year postpartum among Latinas.

The study aims to determine if recent intimate partner violence (IPV) is a prenatal risk factor for postpartum depression (PPD) among pregnant Latinas seeking prenatal care. A prospective observational study followed Latinas from pregnancy through 13 months postpartum. Prenatal predictors of PPD included depression, recent IPV exposure, remote IPV exposure, non-IPV trauma history, poverty, low social support, acculturation, high parity, and low education. Postpartum depression was measured at 3, 7, and 13 months after birth with the Beck's Depression Inventory—Fast Screen. Strength of association was evaluated using bivariate and multivariable odds ratio analysis. Subjects were predominantly low income, monolingual Spanish, and foreign-born, with mean age of 27.7. Recent IPV, prenatal depression, non-IPV trauma, and low social support were associated with greater likelihood of PPD in bivariate analyses. Recent IPV and prenatal depression continued to show significant association with PPD in multivariate analyses, with greater odds of PPD associated with recent IPV than with prenatal depression (adjusted OR = 5.38, p < 0.0001 for recent IPV and adjusted OR = 3.48, p< 0.0001 for prenatal depression). Recent IPV exposure is a strong, independent prenatal predictor of PPD among Latinas. Screening and referral for both IPV and PPD during pregnancy may help reduce postpartum mental health morbidity among Latinas.

Household food insecurity is associated with depressive symptoms among low-income pregnant Latinas

Latinas experience high rates of poverty, household food insecurity and prenatal depression. To date, only one USA study has examined the relationship between household food insecurity and prenatal depression, yet it focused primarily on non-Latina white and non-Latina black populations. Therefore, this study examined the independent association of household food insecurity with depressive symptoms among low-income pregnant Latinas. This cross-sectional study included 135 low income pregnant Latinas living in Hartford, Connecticut. Women were assessed at enrolment for household food security during pregnancy using an adapted and validated version of the US Household Food Security Survey Module. Prenatal depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale. A cut-off of ≥21 was used to indicate elevated levels of prenatal depressive symptoms (EPDS). Multivariate backwards stepwise logistic regression was used to identify risk factors for EPDS. Almost one third of participants had EPDS. Women who were food insecure were more likely to experience EPDS compared to food secure women (OR = 2.59; 95% CI = 1.03-6.52). Being primiparous, experiencing heartburn and reporting poor/fair health during pregnancy, as well as having a history of depression were also independent risk factors for experiencing EPDS. Findings from this study suggest the importance of assessing household food insecurity when evaluating depression risk among pregnant Latinas.

Food insecurity is a risk factor for elevated levels of depression symptoms among low‐income pregnant Latinas

The objective of this study was to determine predictors of elevated levels of prenatal depression symptoms among low‐income Latinas (N=134). Depression symptoms were assessed using the 20‐item Center for Epidemiologic Studies Depression Scale (CES‐D). 24.1% reported elevated levels of depressive symptoms (cutoff value ≥ 24). Multivariate logistic regression was used to determine significant predictors (p&lt;0.10) of elevated levels of prenatal depression symptoms. Participants who experienced food insecurity during pregnancy, measured by an adapted version of the US Household Food Security Survey Module, were 2.7 times more likely to experience elevated levels of prenatal depression symptoms compared to those who were food secure (95% CI: 1.01–7.09). Other risk factors for elevated levels of prenatal depression symptoms were lower levels of social support, experiencing heartburn, self‐perceived poor/fair health, being Puerto Rican, and lower maternal age. These findings suggest that food insecurity, self‐perceived health, and the presence of physical symptoms during pregnancy are important factors for clinicians to measure when evaluating depression risk among low‐income pregnant Latinas. Funded by Connecticut NIH EXPORT Center for Eliminating Health Disparities among Latinos (NIH‐NCMHD Grant # P20MD0017650).

Gestational weight gain knowledge among low‐income pregnant Latinas

The objective of this study was to describe the knowledge about gestational weight gain among low‐income pregnant Latinas (N=136). Based on current IOM guidelines, over 55% of women were overweight or obese before pregnancy. Over 45% of women gained excessive gestational weight during pregnancy. When asked their feelings about how much weight they had gained during pregnancy, almost half reported they felt they had gained too much weight. Only 26% of participants knew the recommended amount of weight they should gain during pregnancy, with 31% reporting an amount less than the recommended, and 29% reporting that they didn't know how much to gain. Only 55% of women reported that a health care provider discussed gestational weight with them, however 50% of those women reported that they weren't specifically told the amount of weight they should gain. These findings show that excessive gestational weight gain is prevalent among low‐income Latinas, yet they are not being advised on appropriate gestational weight gain by health care providers. Interventions targeting dissemination of appropriate gestational weight gain recommendations by health care providers are needed. Funded by Connecticut NIH EXPORT Center for Eliminating Health Disparities among Latinos (NIH‐NCMHD Grant # P20MD0017650).

Egg Contribution Towards the Diet of Pregnant Latinas

Proper nutrition during gestation is important to prevent adverse pregnancy outcomes. Eggs contain many important nutrients necessary for fetal development and human survival. Three focus groups were conducted with Latina women living in Connecticut to identify cultural beliefs toward egg consumption during pregnancy, traditional egg dishes, and methods of preparation. A cross-sectional study was then carried out with a sample of predominately Puerto Rican pregnant Latinas (N = 241) to identify the frequency of consumption of eggs and egg-containing dishes as well as methods of preparation using a tailored food frequency questionnaire modified for this population. Paired sample t-tests were used to examine if there were differences in weekly mean egg intake patterns between the year prior to the pregnancy and during pregnancy based on a Food Frequency Questionnaire. Women were categorized into eggs consumers and non-consumers if they consumed or did not consume eggs during the previous day based on 24-hour recall data. Independent-sample t-test and chi-square cross-tabulation analyses were conducted to examine the association between egg consumption and nutrient intake categories. Results showed that eggs and egg-containing traditional dishes are consumed by Latinas before and during pregnancy. Egg consumers had higher intakes of protein, fat, vitamin K, vitamin E, selenium, beta carotene, lutein and zeaxanthin, cholesterol, total polyunsaturated fatty acids, and docosahexaenoic acid. Eggs contribute significantly to the diet of pregnant Latinas.

Periconceptional binge drinking and acculturation among pregnant Latinas in New Mexico

Binge drinking during pregnancy might lead to the development of Fetal Alcohol Spectrum Disorders in the offspring. Latinas are often considered a low-risk group for alcohol abuse, although recent reports indicate that the prevalence of alcohol consumption in this group is increasing due to changing cultural norms. The predictors of alcohol consumption during pregnancy among Latinas are largely unknown. We explored predictors of periconceptional drinking among Latinas ( n = 155) recruited into an ongoing cohort study at the University of New Mexico. Women were interviewed by a bilingual trained interviewer about any episodes of binge drinking (≥4 drinks/occasion) a month around their last menstrual period (LMP) and were administered a TWEAK questionnaire. Sociodemographic, lifestyle, and reproductive health characteristics were also ascertained. Predictors of binge drinking were identified by Chi-square test and logistic regression in univariate and multivariable analyses, respectively. Backward selection procedure was used to identify covariates that were independently associated with binge drinking in the final model. The mean age of participants was 27.0 ± 5.8 years and 69% were foreign born. In the entire sample, 17.4% of pregnant Latinas admitted at least one binge-drinking episode in the month around their LMP. Results of multivariate analysis indicate that Latinas born in the United States have a much greater risk of binge drinking in the periconceptional period (odds ratio [OR] = 3.2; 95% confidence interval [CI]: 1.2, 8.9) compared with foreign-born Latinas. Similarly, Latinas who primarily speak English at home were at much greater risk (OR = 3.6; 95% CI: 1.3, 10.5) compared with primarily Spanish-speaking women. No other variables were identified as significant predictors in multivariable models. Our results indicate that more acculturated Latinas are at much greater risk of binge drinking before conception and in early pregnancy compared with less acculturated Latinas. Culturally sensitive interventions should be developed to address risky alcohol consumption among Latinas of reproductive age.

Intimate Partner Violence Screening and Pregnant Latinas

Little is known about factors associated with health care screening of intimate partner violence (IPV) for Latinas during pregnancy. This study builds on current research examining IPV-associated outcomes among Latinas by analyzing 210 pregnant Latina responses to a patient survey. A multivariate logistic regression model examined factors associated with being screened for IPV. One-third of pregnant women reported being screened for IPV. Factors related to being screened for IPV are reported and did not match those associated with having experienced IPV. While most pregnant Latinas were not screened for IPV, having systematic processes in place for IPV screening and fostering good patient-provider communication may facilitate identification of IPV. Having a greater awareness of the risk factors associated with IPV may also provide cues for clinicians to better address the issue of IPV.