Relative contributions of maternal social and biological characteristics to birth weight and gestation among mothers of different childhood socioeconomic status

There has been no reported systematic attempt to quantify the relative unique contribution of multiple social and biologic maternal characteristics to birthweight and gestational time among mothers of differing childhood socioeconomic backgrounds. This issue was examined in 3 nativity cohorts from a population of 766 black prenatal clinic patients in New York City using a series of stepwise hierarchical multiple regression analyses. Different variable sets contributed to birthweight variance in each group, although total variance explained was similar for the 3. Since the foreign-born cohort represented a different higher childhood socioeconomic background, but was similar to the other groups in current socioeconomic status, the differing observed associations of variable sets to birthweight may be related to childhood socioeconomic status. In all groups, social factors show more effect on gestation among those births more than 2500 grams than for smaller babies and thus account for more total explained birthweight variance for births over 2500 grams. Future research is necessary to replicate these results in the general population since this is the 1st study using multivariate techniques to look at social and biological factors associated with birthweight in groups with different childhood social backgrounds.     

Hospitalization for heart disease, stroke, and diabetes mellitus among Indian-born persons: a small area analysis

Background

We set out to describe the risk of hospitalization from heart disease, stroke, and diabetes among persons born in India, all foreign-born persons, and U.S.-born persons residing in New York City.

Methods

We examined billing records of 1,083,817 persons hospitalized in New York City during the year 2000. The zip code of each patient's residence was linked to corresponding data from the 2000 U.S. Census to obtain covariates not present in the billing records. Using logistic models, we evaluated the risk of hospitalization for heart disease, stroke and diabetes by country of origin.

Results

After controlling for covariates, Indian-born persons are at similar risk of hospitalization for heart disease (RR = 1.02, 95% confidence interval 1.02, 1.03), stroke (RR = 1.00, 95% confidence interval, 0.99, 1.01), and diabetes mellitus (RR = 0.96 95% confidence interval 0.94, 0.97) as native-born persons. However, Indian-born persons are more likely to be hospitalized for these diseases than other foreign-born persons. For instance, the risk of hospitalization for heart disease among foreign-born persons is 0.70 (95% confidence interval 0.67, 0.72) and the risk of hospitalization for diabetes is 0.39 (95% confidence interval 0.37, 0.42) relative to native-born persons.

Conclusions

South Asians have considerably lower rates of hospitalization in New York than reported in countries with national health systems. Access may play a role. Clinicians working in immigrant settings should nonetheless maintain a higher vigilance for these conditions among Indian-born persons than among other foreign-born populations.     

Relative contributions of maternal social and biological characteristics to birth weight and gestation among mothers of different childhood socioeconomic status

Abstract

There has been no reported systematic attempt to quantify the relative unique contribution of multiple social and biologic maternal characteristics to birth weight and gestational time among mothers of differing childhood socioeconomic backgrounds. We examined this issue in three nativity cohorts from a population of 766 black prenatal clinic patients in New York City using a series of stepwise hierarchical multiple regression analyses. Different variable sets contributed to birth weight variance in each group, although total variance explained was similar for the three. Since the foreign‐born cohort represented a different higher childhood socioeconomic background, but was similar to the other groups in current SES, the differing observed associations of variable sets to birth weight may be related to childhood socioeconomic status. In all groups, social factors show more effect on gestation among births more than 2,500 grams than for smaller babies and thus account for more total explained birth weight variance for births over 2,500 grams.     

Quantifying the Impact of Gestational Diabetes Mellitus,Maternal Weight and Race on Birthweight via Quantile Regression

Background

Quantile regression, a robust semi-parametric approach, was used to examine the impact of gestational diabetes mellitus (GDM) across birthweight quantiles with a focus on maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG).

Methods

Using linked birth certificate, inpatient hospital and prenatal claims data we examined live singleton births to non-Hispanic white (NHW, 135,119) and non-Hispanic black (NHB, 76,675) women in South Carolina who delivered 28–44 weeks gestation in 2004–2008.

Results

At a maternal BMI of 30 kg/m² at the 90^th quantile of birthweight, exposure to GDM was associated with birthweights 84 grams (95% CI 57, 112) higher in NHW and 132 grams (95% CI: 104, 161) higher in NHB. Results at the 50^th quantile were 34 grams (95% CI: 17, 51) and 78 grams (95% CI: 56, 100), respectively. At a maternal GWG of 13.5 kg at the 90^th quantile of birthweight, exposure to GDM was associated with birthweights 83 grams (95% CI: 57, 109) higher in NHW and 135 grams (95% CI: 103, 167) higher in NHB. Results at the 50^th quantile were 55 grams (95% CI: 40, 71) and 69 grams (95% CI: 46, 92), respectively.

Summary

Our findings indicate that GDM, maternal prepregnancy BMI and GWG increase birthweight more in NHW and NHB infants who are already at the greatest risk of macrosomia or being large for gestational age (LGA), that is those at the 90^th rather than the median of the birthweight distribution.     

From Puerto Rican to pan-ethnic in New York city

Abstract

The increasing diversity of the US population has stimulated interest in racial identification, which is complex for phenotypically heterogeneous groups such as Puerto Ricans. We overcome several limitations of the empirical literature on racial identification among Puerto Ricans with a study that is grounded in the experience of Puerto Rican women in New York City. Our analysis focuses on two questions: How do Puerto Rican women in New York identify themselves racially? What are the sources of racial identification? The results indicate that most Puerto Rican women in New York conflate race and ethnicity by designating their race as either ‘Puerto Rican’ or ‘Hispanic’. Moreover, the decision to ‘become’ pan-ethnic has complex roots. In particular, the effect of skin tone on pan-ethnic identification is conditioned by socioeconomic and neighbourhood characteristics.     

Clinical Presentation and Birth Outcomes Associated with Respiratory Syncytial Virus Infection in Pregnancy

Background

Respiratory syncytial virus (RSV) is the most important cause of viral pneumonia in children worldwide. A maternal vaccine may protect both the mother and infant from RSV illness. The epidemiology and clinical presentation of RSV in pregnant and postpartum women is not well-described.

Methods

Data were collected from a prospective, randomized trial of influenza immunization in pregnant women in rural southern Nepal. Women were enrolled in their second trimester of pregnancy and followed until six months postpartum. Active weekly home-based surveillance for febrile respiratory illness was performed. Mid-nasal swabs collected with episodes of respiratory illness were tested for RSV by real-time polymerase chain reaction.

Results

RSV was detected in 14 (0.4%) illness episodes in 3693 women over 3554 person-years of surveillance from 2011–2014. RSV incidence was 3.9/1000 person-years overall, and 11.8/1000 person-years between September and December. Seven (50%) women sought care for RSV illness; none died. Of the 7 (50%) illness episodes during pregnancy, all had live births with 2 (29%) preterm births and a median birthweight of 3060 grams. This compares to 469 (13%) preterm births and a median birthweight of 2790 grams in women without RSV during pregnancy. Of the 7 mothers with postpartum RSV infection, RSV was detected in 4 (57%) of their infants.

Conclusions

RSV was an uncommon cause of febrile respiratory illness in mothers during pregnancy in Nepal. These data will inform prevention and therapeutic strategies against RSV in resource-limited settings.     

Prevalence Rates of Uterine Cervical Carcinoma in situ for Women Using the Diaphragm or Contraceptive Oral Steroids

Study of the prevalence rates of uterine cervical carcinoma in situ among women attending centres of Planned Parenthood of New York City, Inc., showed a small but statistically significant difference between the population choosing and using the diaphragm and the population choosing and using oral steroids for contraception. This can be attributed either to a decreased prevalence rate for women using the diaphragm or to an increased rate for women using oral steroids. The reason for the difference is not apparent from these data.     

Black Diversity in New York City: West Indians, Haitians, African Americans

Islands in the City: West Indian Migration to New York. Nancy Foner. ed. Berkeley: University of California Press, 2001.312 pp.
Trends in Ethnic Identification among Second-Generation Haitian Immigrants to New York City. Flore Zephir. Westport, CT: Bergin and Garvey, 2001. 248 pp.     

Dispersal dynamics of SARS-CoV-2 lineages during the first epidemic wave in New York City

During the first phase of the COVID-19 epidemic, New York City rapidly became the epicenter of the pandemic in the United States. While molecular phylogenetic analyses have previously highlighted multiple introductions and a period of cryptic community transmission within New York City, little is known about the circulation of SARS-CoV-2 within and among its boroughs. We here perform phylogeographic investigations to gain insights into the circulation of viral lineages during the first months of the New York City outbreak. Our analyses describe the dispersal dynamics of viral lineages at the state and city levels, illustrating that peripheral samples likely correspond to distinct dispersal events originating from the main metropolitan city areas. In line with the high prevalence recorded in this area, our results highlight the relatively important role of the borough of Queens as a transmission hub associated with higher local circulation and dispersal of viral lineages toward the surrounding boroughs.     

Mental Health Aspects of Shoplifting

A ten-year follow-up of 886 shoplifters showed clear differences between women and men. Men tended to have previous convictions and to steal books (unknown in women). Of the 532 women nearly one third were foreign-born, and this group comprised 46% of offenders aged 17-30. The peak age among British women was 51-60.First offenders accounted for 80% of the women, and their reconviction rate was 11%; among those with any kind of previous conviction the rate was 50%. The rate of admission to hospital for women shoplifters is three times higher than average.     

Dog bites in New York City

The purpose of this review is to characterize the public health problem of dog bites in New York City. Dog bites represent a major source of morbidity, mortality, disability, and health care cost in the United States. The most severe injuries are frequently referred to the plastic surgeon. The authors have recently treated several severe cases of unprovoked dog attacks in children. To characterize the dog bite problem in New York City, data were obtained for 1998 from the New York City Department of Health. During that year, 6568 bites were reported by the mandated physician reporters in the five boroughs of New York City. The upper extremities, lower extremities, and face were predominantly affected. The peak incidence occurred during the summer months and in children ages 7 to 9 years old. Preventive measures are discussed.     

Ethnic culture and social mobility among second-generation Asian Americans

ABSTRACT

This review engages with Jennifer Lee and Min Zhou’s The Asian American Achievement Paradox to consider how ethnic culture matters for social mobility among the immigrant second generation. It describes the strengths and contributions of the book, connects it to broader debates on culture, poverty, and mobility, and draws on my own research on the second generation in New York City. It highlights three additional cultural mechanisms that underlie the Chinese (or Asian) second-generation advantage: social class heterogeneity in the co-ethnic community, intergenerational support in the immigrant family, and the belief in achievements as redemption for parental sacrifice. While pointing out the similarities and differences between Los Angeles and New York, it also suggests possible applications of these cultural mechanisms in explaining second-generation achievements.     

Birth Outcomes of Latin Americans in Two Countries with Contrasting Immigration Admission Policies: Canada and Spain

Background

We delved into the selective migration hypothesis on health by comparing birth outcomes of Latin American immigrants giving birth in two receiving countries with dissimilar immigration admission policies: Canada and Spain. We hypothesized that a stronger immigrant selection in Canada will reflect more favourable outcomes among Latin Americans giving birth in Canada than among their counterparts giving birth in Spain.

Materials and Methods

We conducted a cross-sectional bi-national comparative study. We analyzed birth data of singleton infants born in Canada (2000–2005) (N = 31,767) and Spain (1998–2007) (N = 150,405) to mothers born in Spanish-speaking Latin American countries. We compared mean birthweight at 37–41 weeks gestation, and low birthweight and preterm birth rates between Latin American immigrants to Canada vs. Spain. Regression analysis for aggregate data was used to obtain Odds Ratios and Mean birthweight differences adjusted for infant sex, maternal age, parity, marital status, and father born in same source country.

Results

Latin American women in Canada had heavier newborns than their same-country counterparts giving birth in Spain, overall [adjusted mean birthweight difference: 101 grams; 95% confidence interval (CI): 98, 104], and within each maternal country of origin. Latin American women in Canada had fewer low birthweight and preterm infants than those giving birth in Spain [adjusted Odds Ratio: 0.88; 95% CI: 0.82, 0.94 for low birthweight, and 0.88; 95% CI: 0.84, 0.93 for preterm birth, respectively].

Conclusion

Latin American immigrant women had better birth outcomes in Canada than in Spain, suggesting a more selective migration in Canada than in Spain.     

Does the Hispanic health advantage extend to better management of hypertension? The role of socioeconomic status,sociobehavioral factors,and health care access

Hispanics in the United States (and foreign-born Hispanics in particular) have relatively favorable health given their lower socioeconomic status compared to, for example, non-Hispanic whites. This phenomenon is often called the Hispanic health paradox (HHP). This study examines whether the previously documented HHP in hypertension prevalence extends to its management using clinical and self-reported measures from the 2007–2012 National Health and Nutrition Examination Surveys. Multivariate models adjusting for demographic, socioeconomic, and sociobehavioral characteristics show an advantage among foreign-born Mexicans in hypertension prevalence relative to non-Hispanic whites (adjusted OR = 0.85). However, compared to non-Hispanic whites, foreign-born Mexicans were 38% less likely to receive treatment recommendations and, when advised to undergo treatment, were 60% less likely to adhere to treatment. Adjusting for health care access and utilization dramatically reduces disparities in hypertension control between foreign-born Mexicans and non-Hispanic whites, suggesting that insufficient systematic access to and use of quality health care erodes the HHP and contributes to the deterioration of health throughout the immigrant experience. Without appropriate interventions, particularly in health care access and utilization, poorer hypertension management among foreign-born Mexicans may negatively affect the Hispanic health profile, increase risk of cardiovascular disease-related mortality, and erode the Hispanic health advantage in the future.     

Marionettes as Recreational Art Activities in the Chicago Parks

Rembrandt Drawings: The Overlook Press New York City 10022 $12.95. Reviewed by B. Haak

The Decoupage Workshop: Doubleday &; Company, Inc. New York City 10017 $12.95. Reviewed by Leslie Linsley

A Cabinetmaker's Notebook: Van Nostrand Reinhold Company New York City 10001 $13.50. Reviewed by James Krenov

Alkema's Scrap Magic: Sterling Publishing Co., Inc. New York City 10016 $12.95. Reviewed by Chester Jay Alkema

Things to Do in a Day Macmillan Publishing Co., Inc. $8.95 cloth New York City 10022 $5.95 paper.     

Will "Combined Prevention" Eliminate Racial/Ethnic Disparities in HIV Infection among Persons Who Inject Drugs in New York City?

It has not been determined whether implementation of combined prevention programming for persons who inject drugs reduce racial/ethnic disparities in HIV infection. We examine racial/ethnic disparities in New York City among persons who inject drugs after implementation of the New York City Condom Social Marketing Program in 2007. Quantitative interviews and HIV testing were conducted among persons who inject drugs entering Mount Sinai Beth Israel drug treatment (2007–2014). 703 persons who inject drugs who began injecting after implementation of large-scale syringe exchange were included in the analyses. Factors independently associated with being HIV seropositive were identified and a published model was used to estimate HIV infections due to sexual transmission. Overall HIV prevalence was 4%; Whites 1%, African-Americans 17%, and Hispanics 4%. Adjusted odds ratios were 21.0 (95% CI 5.7, 77.5) for African-Americans to Whites and 4.5 (95% CI 1.3, 16.3) for Hispanics to Whites. There was an overall significant trend towards reduced HIV prevalence over time (adjusted odd ratio = 0.7 per year, 95% confidence interval (0.6–0.8). An estimated 75% or more of the HIV infections were due to sexual transmission. Racial/ethnic disparities among persons who inject drugs were not significantly different from previous disparities. Reducing these persistent disparities may require new interventions (treatment as prevention, pre-exposure prophylaxis) for all racial/ethnic groups.     

Congenital malformations in offspring of Hispanic and African-American women in California, 1989-1997

BACKGROUND: Little is known about risks of most specific birth defects among infants born to U.S.-born and foreign-born Hispanic or African-American women. METHODS: Using data from a large population-based registry, we explored risks of selected congenital malformation phenotypes in offspring of U.S.-born and foreign-born Hispanic and African-American women, relative to non-Hispanic white women, in California. Approximately 2.2 million live births and stillbirths occurred during the ascertainment period, 1989-1997. Information on maternal racial-ethnic background and other covariates was obtained from birth certificate and fetal death files. RESULTS: Adjusted relative risks (ARRs) for the 20 groupings of malformations designated by three-digit British Pediatric Association (BPA) codes ranged from 0.6 (genital organ malformations, among infants born to foreign-born Hispanics) to 1.7 (anencephaly, also among infants born to foreign-born Hispanics). Grouping by four-digit BPA codes revealed that among infants born to U.S.-born Hispanics, 46 of the ARRs were < or = 0.8 and 12 were > or = 1.3; among infants born to foreign-born Hispanics, 75 of the ARRs were < or = 0.8 and 15 were > or = 1.3; and among infants born to African-American women, 45 ARRs were < or = 0.8 and 25 were > or = 1.3. For each racial-ethnic group of women, the observed variability in risks covered most organ systems. CONCLUSIONS: Although the results suggested that (in comparison with non-Hispanic whites) each racial-ethnic group was more likely to have reduced risk for specific defects (rather than elevated risk), in general, the range of the relative risks was comparatively narrow.     

Obesity,Social Class,and Mental Illness

The relationship between obesity and mental health was investigated, using data obtained from 1,660 persons selected as representative of 110,000 inhabitants of a residential area of New York City. In addition to confirming the previously noted relationship between obesity and age, preliminary analysis revealed a striking relationship between obesity and socioeconomic status of origin. The prevalence of obesity was 7 times higher among women reared in the lowest social class category as compared with those reared in the highest category. Scores made by the obese respondents on 9 mental health indices were compared with scores made by individuals of average weight. The obese respondents made more pathological scores on 8 of the 9 measures and on 3 of these the difference was statistically significant (“immaturity,” “rigidity,” and “suspiciousness”).     

A survey of the parasites of coyotes (Canis latrans) in New York based on fecal analysis

Coyotes (Canis latrans) have colonized northeastern North America only within the past 10-80 yr. We examined feces of coyotes in 2000-01 at three sites in New York (USA) to survey parasites in the region. Two cestodes, nine nematodes, five protozoa, one trematode, and two arthropods were identified from 145 coyote fecal samples. Parasite component community diversity was higher (n = 16 species) in southern New York than in middle and northern sites (nine species each) and infracommunity species richness was greater in southern New York than at the other sites. These differences may reflect the variable diets of coyotes, as well as recent colonization of the region and the mixing of component communities from expanding coyote populations.     

Alcohol dependence patterns and their impact on New York City

As a follow-up to a national survey by the Community Anti-Drug Coalitions of America (CADCA), an expert panel was convened to discuss local alcoholism data from New York, NY. The impact of alcoholism on the US economy is estimated at $185 billion annually. About 15% of New Yorkers drink alcohol excessively, with the highest percentage in Manhattan (22%). Over 135,000 New York City residents are admitted for alcohol treatment. Alcohol dependency is highest among whites (21%), followed by Latinos (14.8%) and African Americans (11%). Despite lower levels of excessive drinking, African-American and Latino New Yorkers are more likely than white New Yorkers to be hospitalized or die as a result of excessive drinking. The barriers to overcome are the lack of information on treatment options, the stigma of alcoholism, the lack of physician education, and a limited number of treatment facilities/personnel. Patients need behavioral counseling, a commitment to treatment, and compliance with medication if they are to succeed in treatment.