Summary
Background: The population of Pacific Islanders in the United States is rapidly increasing, largely due to immigration. Pacific Islander mothers may be more likely to experience adverse prenatal and perinatal outcomes. However, data are limited. In order to improve the health of Pacific Islanders residing in the United States, it is essential to document obstetric outcomes in this understudied, diverse population. Methods: This study used data from the All-California, Rapid-Cycle, Maternal/Infant Database to compare prenatal and perinatal outcomes among Pacific Islander immigrants who gave birth to their first, singleton infant in California between 2008 and 2012. Pacific Islander immigrants were disaggregated into the following groups: Hawaiian, Guamanian, Samoan, Fijian and Tongan. Bivariate analyses were performed comparing obstetric outcomes and potential risk factors among these Pacific Islander subgroups. The impact of race/ethnicity on gestational diabetes and birth weight was examined using multivariable logistic regression models, controlling for relevant sociodemographic and health risk factors. Results: Significant differences were seen in demographic characteristics and perinatal outcomes across Pacific Islander subgroups. Maternal race/ethnicity was found to be independently associated with gestational diabetes mellitus, low birth weight and macrosomia. Fijian mothers had increased odds of gestational diabetes compared to all other subgroups. Samoan and Tongan mothers had decreased odds of low birth weight and increased odds of giving birth to macrosomic infants compared to Fijian mothers. Conclusions: Important differences in prenatal and perinatal outcomes exist between subgroups of Pacific Islander immigrants. Future research, interventions and policy must acknowledge this racial/ethnic heterogeneity among Pacific Islanders and address the unique health needs of these subgroups.