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The Hispanic Paradox in Twin Pregnancies

Published online by Cambridge University Press:  21 February 2012

Barbara Luke*
Affiliation:
University of Miami School of Nursing and Health Studies, Coral Gables, Florida, United States of America. b.luke@miami.edu
Morton B. Brown
Affiliation:
Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America.
Ruta B. Misiunas
Affiliation:
Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, Michigan, United States of America.
Victor H. Gonzalez-Quintero
Affiliation:
Department of Obstetrics & Gynecology, University of Miami, Florida, United States of America.
Clark Nugent
Affiliation:
Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, Michigan, United States of America.
Cosmas van de Ven
Affiliation:
Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, Michigan, United States of America.
Frank R. Witter
Affiliation:
Department of Gynecology & Obstetrics, Johns Hopkins University, Baltimore, Maryland, United States of America.
Roger B. Newman
Affiliation:
Department of Obstetrics & Gynecology, Medical University of South Carolina, Charleston, South Carolina, United States of America.
Mary D'Alton
Affiliation:
Department of Obstetrics & Gynecology, Columbia University, New York, United States of America.
Gary D. V. Hankins
Affiliation:
Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, Texas, United States of America.
David A. Grainger
Affiliation:
Department of Obstetrics & Gynecology, University of Kansas, Wichita, Kansas, United States of America.
George A. Macones
Affiliation:
Department of Obstetrics & Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
*
**Address for correspondence: Barbara Luke, ScD, School of Nursing and Health Studies, University of Miami, 5801 Red Road, Coral Gables, FL 33143, USA.

Abstract

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The objective of this study was to compare length of gestation, fetal growth, and birthweight by race/ethnicity and pregravid weight groups in twin pregnancies. Three thousand and thirty-six twin pregnancies of 28 weeks or more gestation were divided by race/ethnicity (White, Black and Hispanic), and pregravid body mass index (BMI) groups (less than 25.0 vs. 25.0 or more). Outcomes were modeled using multiple regression, controlling for confounders, with White non-Hispanic women as the reference group. Hispanic women had the highest average birthweight and the longest gestation, as well as the lowest proportions of low birthweight, very low birthweight, preterm and early preterm births of the 3 race/ethnicity groups. In the multivariate analyses, Hispanic women had significantly longer gestations (by 7.8 days) and faster rates of fetal growth midgestation (20 to 28 weeks, by 17.4 g/week) and late gestation (after 28 weeks, by 5.3 g/week), whereas Black women had significantly slower rates of fetal growth (by 5.7 g/week and by 4.5 g/week, respectively). These findings in twins reflect the racial and ethnic disparities previously shown in singletons, including the Hispanic paradox of longer gestations and higher rates of fetal growth.

Type
Articles
Copyright
Copyright © Cambridge University Press 2005