The aim of this study was to assess potential prepregnancy risk factors for preterm birth in a low-income, Hispanic population in Southern California. Additionally, the study assessed whether the prevalence of preterm birth and any associations between risk factors and preterm birth differed between U.S.- and foreign-born mothers. The study sample included 1,174 mothers participating in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) within 1 year postpartum, including an augment sample of mothers who delivered preterm. Maternal sociodemographic traits, prepregnancy health-related characteristics and behaviors, and birth outcomes were collected by telephone survey. Odds ratios for associations between risk factors and preterm birth were estimated by logistic regression with sampling weights. Effect measure modification of any association by maternal nativity was also assessed using interaction terms. After adjustment for confounding, significant prepregnancy risk factors for preterm birth included maternal age ≥35 y (OR = 2.00; 95% CI: 1.04, 3.84) compared to age 18–24 y, and experience of a financially stressful life event among U.S.-born, but not foreign-born, women (OR = 2.61; 95% CI: 1.43, 4.77). The weighted prevalence of preterm birth was 15.1% and did not significantly differ by maternal nativity (P = 0.19). Further investigation with large, prospective studies is needed to better understand the risk factors for and disparities in preterm birth among the growing Hispanic population in the U.S. so that women who are at risk prepregnancy can be identified and provided risk-specific services.

In this urban population of WIC children with high baseline immunization coverage, A/R was not effective in increasing immunization coverage.

Objective To describe the postpartum health of predominantly Hispanic WIC participants and identify how health characteristics differ between mothers who delivered preterm or low birthweight infants and those who did not. Design Cross-sectional survey among postpartum WIC mothers. Setting Los Angeles and Orange Counties, California. Participants WIC participants within 1 year of delivery (n = 1,420). Main Outcome Measures Postpartum health behaviors, health characteristics, and birth spacing intentions and behaviors. Analysis The frequencies of health characteristics were estimated using analyses with sample weights. Differences were assessed with chi-square and Fisher's exact tests with a Bonferroni correction for pairs of tests. Results Many women exhibited postpartum risk factors for future adverse health events, including overweight or obesity (62.3%), depressive symptoms (27.5%), and no folic acid supplementation (65.5 %). Most characteristics did not differ significantly (P>0.025) between mothers of preterm infants and full-term infants or between mothers of low birthweight and normal birthweight infants. Conclusions and Implications Despite few differences between postpartum characteristics of mothers who delivered preterm or low birthweight infants and those who did not, a high percentage of mothers had risk factors that need to be addressed. Current postpartum educational activities of WIC programs should be evaluated and shared.

Among the gaps identified in the 2009 revision of the Institute of Medicine (IOM) recommendations for gestational weight gain (GWG) was the paucity of GWG data on women from racial or ethnic minority groups. The objective of this study was to examine GWG trends among participants of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in Southern California, 84% of whom are Hispanic. We examined WIC administrative data on 27,646 women with full term pregnancies who enrolled in WIC in the first trimester and had their last prenatal WIC visit within one month of their expected delivery date. We examined trends in excessive GWG according to the 2009 IOM guidelines for total weight gain during pregnancy, based on pre‐pregnancy BMI. Overall, 24.6% of women gained above the IOM recommendations, and this percentage varied greatly by race/ethnicity. Among Hispanic English speakers, 30% gained above the IOM recommendations compared to 18.7% of Hispanic Spanish speakers (for all Hispanics, the rate was 23.9%). Among Hispanic mothers less than 20 years of age, 28.9% gained above the IOM guidelines compared to 19.8% of Hispanic mothers aged 35 or older. Rates of excessive GWG were lowest among Asians (16.6%) and highest among, Whites (37.3%), African Americans (37.6%) and Native Americans (38.8%). Among those who started pregnancy overweight or obese, 61.4% gained above the IOM recommendations vs. 13.6% of those who entered pregnancy at a normal BMI. Given the wide reach of the WIC program, WIC administrative data have significant potential to help fill the existing gaps in GWG surveillance. Funding for this research was provided by the USDA FNS through a grant for WIC administered by the CA DPH.