Differences in socioeconomic position, lifestyle and health-related pregnancy characteristics between Pakistani and White British women in the Born in Bradford prospective cohort study: the influence of the woman's, her partner's and their parents’ place of birth

Abstract

ObjectiveTo examine differences between Pakistani and White British women in relation to socioeconomic position, lifestyle and health-related pregnancy characteristics, and to determine whether these differences vary depending on the woman's, her partner's and both of their parents’ place of birth.DesignProspective cohort study.SettingBradford, UKParticipants3656 Pakistani and 3503 White British women recruited to the Born in Bradford study.Main outcome measuresSocioeconomic position (employment status; level of education; receipt of benefits; housing tenure), lifestyle characteristics (body mass index (BMI) at the start of pregnancy; smoking during pregnancy) and health-related pregnancy characteristics (hypertensive disorders of pregnancy; gestational diabetes; fasting glucose, postload glucose and fasting insulin at ∼27 weeks gestation).ResultsFewer Pakistani women were employed (OR 0.17, 95% CI 0.15 to 0.19), the difference being markedly less for UK born women. UK born Pakistani women were more likely, and South Asian born less likely, to be educated post 16 than White British women. Smoking was uncommon among Pakistani women, though the difference comparing UK born Pakistani women to White British women was less than for other groups. BMI was lower among Pakistani compared to White British women (adjusted mean difference −1.12, 95% CI −1.43 to −0.81), the difference being greatest when partners were UK born irrespective of the woman’s place of birth. Pakistani women had higher fasting and postload glucose (mean difference 0.20 mmol/L, 95% CI 0.17 to 0.24; 0.37, 95% CI 0.28 to 0.45), higher fasting insulin and were more likely to have gestational diabetes (GDM).ConclusionsOur results suggest that some socioeconomic, lifestyle and pregnancy characteristics could be beginning to change in response to migration to the UK, with generally beneficial changes, that is, improving education and employment prospects, lower BMI and no evidence that being UK born has further increased the risk of GDM, but some negative, that is, slight increases in smoking.

Objectively-measured sedentary time and physical activity in a bi-ethnic sample of young children: variation by socio-demographic, temporal and perinatal factors

“…This could indicate that meaningful ethnic differences only manifest when children are older, which would imply that early prevention is key to preventing ethnic inequalities in physical activity. Alternatively, second generation UK South Asians are more likely to be educated beyond school [35], and they purportedly have different attitudes to physical activity and are more active compared to the first (migrant) generation [8]. Plausibly, as knowledge, attitudes and behaviours in the youngest generation of UK South Asians and their UK born parents have continued to change, this may have translated to parity in children's physical activity levels compared to the white British.…”

Associations of Pregnancy Physical Activity with Maternal Cardiometabolic Health, Neonatal Delivery Outcomes and Body Composition in a Biethnic Cohort of 7305 Mother–Child Pairs: The Born in Bradford Study

“…Adjustment for maternal family history of high blood pressure and diabetes was also carried out, as was whether Pakistani-origin women and their partners were born in Pakistan or the UK. The latter attempted to control for lifestyle and health-related pregnancy characteristics related to acculturation or Westernisation [43]. We also adjusted for the year of cord blood analysis to correct for potential batch effects.…”

Specific antenatal interventions for Black, Asian and Minority Ethnic (BAME) pregnant women at high risk of poor birth outcomes in the United Kingdom: a scoping review

“…These include language barriers; whereby women do not have access to properly skilled translators (this includes health literate translators) [ 27 – 29 ]; unawareness of service provision or how to access services [ 30 ]; poor access to female health care staff, embarrassment of unknown male medical staff [ 31 , 32 ]; physical restrictions due to socio-demographic limitations such as hospital proximity and access to transport [ 33 , 34 ] and poor previous experience of health care services or stereotyped expectations from health care staff resulting in reductions in information giving and informed choices [ 32 , 35 ]. Other contributory risk factors, such as socioeconomic status, including education status and income, and living in areas of high deprivation are frequently cited as distal determinants of poorer health outcomes [ 14 , 22 , 36 ].…”