A comparison of pregnancy course and outcome between 648 Hmong refugee women and 5278 non-Hmong controls, all of whom delivered at a Minnesota medical center in 1976-83, indicated that Hmong women were 5 times as likely to have a history of previous perinatal loss. In terms of demographic factors, Hmong women were more likely to be age 35 years or above at delivery (14% versus 2% among controls), to be grant multiparas (33% versus 3% among controls), and to be married (95% versus 61% among controls). While 59% of controls began prenatal care during the 1st trimester, only 16% of Hmong women fell into this category and 31% delayed receiving care until the 3rd trimester. A review of the obstetric histories revealed that 18.1% of Hmong women compared with 3.7% of controls had experienced 1 or more previous perinatal loss. Medical conditions found with significant frequency in the Hmong population included anemia, tuberculosis, malaria, and parasitic infestations. Preeclampsia, hypertension, diabetes, urinary and vaginal infections, and gonorrhea occurred less frequently among Hmong women than among controls. Moreover, the incidence of premature rupture of the membranes was only 4.2% among Hmong women compared to 11.8% among controls. The prematurity rate was 48.5/1000 in the study group and 117/1000 in controls; in addition, only 7.8% of Hmong infants compared to 10.9% of control infants were low birthweight (under 2500 grams). The perinatal mortality rate was similar in both groups: 14.6/1000 among Hmong infants and 15.0/1000 among controls. Contraception was accepted by 50% of the Hmong mothers, but under 10% remained users 12 months after delivery and 27% were pregnant again. The generally good pregnancy outcomes recorded among these Hmong women despite the existence of numerous high-risk factors--short stature, advanced maternal age, grand multiparity, late prenatal care, and poor nutrition--is surprising. It appears that relocation to the US has enabled this population to overcome the factors that contributed to their previous high rates of perinatal loss.

[No Keywords available]

Studies Reproduction biology Research Methodology Comparative Studies Americas refugee prenatal care population Migrants developing country Laos pregnancy complication Population Dynamics Pregnancy Complications human Developing Countries Refugees pregnancy outcomes Asia health service Developed Countries comparative study Minnesota ethnology health United States North America Adolescent female risk factor Risk Factors Contraception Western Hemisphere pregnancy health services Article Maternal-child Health Services pregnancy outcome Support, Non-U.S. Gov't adult migration developed country Demographic Factors Southeastern Asia Refugees--women Infant Mortality fetus death Northern America Delivery of Health Care Maternal Health Services Fetal Death mortality primary health care Middle Age health care delivery