The relationships among acculturation, biobehavioral risk, stress, corticotropin-releasing hormone, and poor birth outcomes in Hispanic women.

OBJECTIVE To determine the predictive ability of acculturation as an antecedent of stress, biobehavioral risk, corticotropin-releasing hormone levels, and poor birth outcomes in pregnant Hispanic women. DESIGN A prospective, observational design with data collected at 22-25 weeks of gestation and at birth through medical record review. SETTING Public prenatal health clinics in south Texas serving low-income women. PARTICIPANTS Self-identified Hispanic women who had singleton pregnancies, no major medical risk complications, and consented to answer questionnaires as well as a venipuncture and review of their prenatal and birth medical records. MAIN OUTCOME MEASURES Gestational age, Apgar scores, length, weight, percentile size, and head circumference of the infant at birth. RESULTS Significant differences were seen in infant birth weight, head circumference, and percentile size by acculturation. English acculturation predicted stress, corticotropin-releasing hormone, biobehavioral risk, and decreased gestational age at birth. CONCLUSIONS Investigation must continue to understand the circumstances that give rise to the decline in birth outcomes observed in Hispanics with acculturation to the dominant English culture in the United States.