The purpose of this study was to determine whether stress, sleep disturbance, or fatigue at 22 to 26 weeks of gestation is related to the incidence of preterm labor and birth in military women. Data were collected prospectively by questionnaires measuring factors contributing to preterm labor and birth. Hours worked per week were ascertained by telephone until the participants delivered. Postpartum medical records were reviewed for pregnancy outcomes. There was a trend for preterm labor to be associated with lower perceived fatigue severity, low sleep disturbance, and more negative life events. Officer rank was related to both preterm labor and delivery. Findings indicate that the perception of fatigue may be protective against preterm birth and that military officer rank is a risk factor for preterm labor and birth.

No abstract

Research has shown that health outcomes for urban women of Mexican descent are related to acculturation. The purpose of this research was to compare perinatal outcomes of 773 women of Mexican descent who gave birth in three rural northern California hospitals, in relation to acculturation measured three different ways: by place of birth, by language spoken, and by the two factors combined as an Acculturation Index (AI). The prenatal and birth records of 773 Mexico-born or U.S.-born women of Mexican descent were reviewed. Results showed that language spoken was a less useful indicator of acculturation associated with perinatal complications than place of birth or the AI. The categorization of acculturation with the AI enhanced understanding of more specific groups of rural women and their particular health outcomes.

No abstract

Early and consistent prenatal care (PNC) is thought to play an important role in the reduction of low birthweight (LBW) in the United States. It has been reported that LBW and delayed PNC are common to the Hispanic woman. In California, this cultural group comprises approximately 26% of the population, and much debate concerning health care reform has been targeted at this problem. A comparative study was conducted in California to examine the number of prenatal visits and the outcomes of Mexico-born Hispanics and U.S.-born Hispanics. Obstetric and medical record review for 783 women was done. The results show that more prenatal visits did not improve the outcome during pregnancy, labor, or the postpartum period. Because a large portion of PNC is now delivered by the advanced practice nurse, implications for practice include exploring alternatives for the delivery of culturally relevant care, addressing the barriers to caring for this population, and finding alternative models of care that have the potential to produce positive outcomes.