Background Although prior studies have shown disparities in maternal health behaviors according to race/ethnicity and acculturation, whether these patterns are evident among new immigrant populations remains unclear. Purpose To examine the associations among proxies of acculturation and maternal smoking during pregnancy and breastfeeding initiation within each major ethnic group in Massachusetts. Methods Data were from the Standard Certificate of Live Births on 1,067,375 babies by mothers from 31 ethnic groups for 1996-2009. Mothers reported whether they smoked during pregnancy and the birth facility recorded whether mothers started breastfeeding. The acculturation proxy combined mothers' country of birth and language preference: U.S.-born, foreign-born English-speaking, and foreign-born non-English speaking. For each ethnic group, adjusted logistic regression models were used to examine associations between the acculturation proxy and whether mothers smoked or initiated breastfeeding. Data were analyzed from 2012 to 2013. Results A lower proportion of foreign-born mothers had a high school degree or private insurance than U.S.-born mothers. However, foreign-born mothers who were English (range of AORs=0.07-0.93) or non-English speakers (AORs=0.01-0.36) were less likely to smoke during pregnancy than their U.S.-born counterparts. Foreign-born mothers who were English (AORs=1.22-6.52) or non-English speakers (AORs=1.35-10.12) were also more likely to initiate breastfeeding compared to U.S.-born mothers, except for some mothers with Asian ethnicities. Conclusions The consistency of the associations of being foreign-born with less smoking and more breastfeeding suggests that for the majority of ethnic groups studied, acculturation in the U.S. results in poorer maternal health behaviors. © 2014 American Journal of Preventive Medicine.

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Massachusetts health disparity health insurance human epidemiology Health Behavior Ethnic Groups statistics and numerical data ethnic group Maternal Behavior Logistic Models ethnology Breast Feeding United States Humans migrant smoking Emigrants and Immigrants maternal smoking Acculturation female newborn pregnancy cultural factor birth certificate Article major clinical study adult maternal welfare statistical model Birth Certificates Proxy