Journal of Community Health

, Volume 19, Issue 5, pp 319–330 | Cite as

Fetal deaths in Mexican-American, black, and white non-Hispanic women seeking government-funded prenatal care

  • Sylvia Guendelman
  • Gilberto Chavez
  • Roberta Christianson


Hispanics of Mexican origin constitute the largest minority population in the Southwestern United States, yet little is known about their reproductive health. This study assessed ethnic differentials in fetal mortality at 20 or more weeks gestation and identified the social and behavioral predictors associated with this outcome among low-income Hispanic, black non-Hispanic and white non-Hispanic women. Records were used of 80,431 patients attending federally funded prenatal care clinics in California from 1984 through 1989. The fetal death rate per 1,000 liver births and fetal deaths was 7.8 for Hispanic, 8.4 for white non-Hispanic and 20.5 for black non-Hispanic women. These rates indicated favorable reproductive outcomes for Mexican Americans despite their social risk profile. An analysis of stillbirths by gestational age showed that Hispanic women stood a significantly lower risk of short-gestational stillbirths than non-Hispanics. In contrast, Hispanic women had a higher proportion of term stillbirths. Hispanic acculturation was a significant predictor of short-term gestation fetal deaths only. The inability to pay for health care was a strong predictor of fetal deaths for all ethnic groups, underscoring the need to ensure adequate access to maternity care for low-income women.


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  1. 1.
    1990 Census Data, Preliminary Results, State of California.Google Scholar
  2. 2.
    California Department of Health Services Plan for the Maternal and Child Health Year 2000 Objectives, August 1991.Google Scholar
  3. 3.
    Becerra, J, Hogue, C, Atrash, A, Perez, N, Infant mortality among Hispanics,JAMA, 265:217–221, 1991.Google Scholar
  4. 4.
    Williams, RL, Binkins, NJ, Clingman, EJ, Pregnancy outcome among Spanish-surname women in California,AJPH, 76: 387–391, 1986.Google Scholar
  5. 5.
    Markides, KS, Coreil, J, The health of Hispanics in the southwestern United States: An epidemiological paradox,Public Health Rep, 101:253–265, 1986.Google Scholar
  6. 6.
    Dowling, PT, Fisher, M, Maternal factors and low birthweight infants: A comparison of blacks with Mexican Americans,J Family Practice, 25:153–158, 1987.Google Scholar
  7. 7.
    U.S. Department of Health and Human Services (DHHS).Report of the Secretary's Task Force on Black and Minority Health, Vol. 1, Executive Summary, Vol. 6, Infant Mortality, Washington, D. C., 1985.Google Scholar
  8. 8.
    Shiono, PH., Klebanoff, MA, Graubard, BI, Berendes, HW, Rhoads, GG, Birthweight among women of different ethnic groups,JAMA 225;48–52, 1986.Google Scholar
  9. 9.
    Hedderson, J, Daudistel, H, Infant mortality of the Spanish surname population,Soc Sci J, 199:68–78, 1982.Google Scholar
  10. 10.
    Eberstein, J., Pol L. Mexican-American ethnicity, socioeconomic status, and infant mortality: A county level analysis,Soc Sci J, 19:61–71, 1982.Google Scholar
  11. 11.
    Guendelman, S, Gould, J, Hudes, M, Eskenazi, B, Generational differences in perinatal health among the Mexican American population: Findings from HHANES 1982–84,AJPH, 80:61–64, 1990 (suppl.).Google Scholar
  12. 12.
    Greb, A, Pauli, R, Kirby, R, Accurary of fetal death reports: Comparison with data from an independent assessment program,AJPH, 77:1202–1206, 1987.Google Scholar
  13. 13.
    Williams, R, Creasy, R, Cunningham, G, Hawes, W, Norris, F, Tashiro, M, Fetal growth and perinatal viability in California,Obstet Gynecol, 59:624–632, 1982.Google Scholar
  14. 14.
    Padilla, A.Acculturation. Boulder, CO: Westview Press, 1980.Google Scholar
  15. 15.
    Chavez, L, Cornelius, W, Jones, D, Mexican immigrants and the utilization of U.S. health services: The case of San Diego. Social Science and Medicine, 21: 93–102, 1985.Google Scholar
  16. 16.
    Guendelman, S, Jasis, M, Giving birth across the border: The San Diego-Tijuana Connection,Soc Sci and Med 34:419–425, 1992.Google Scholar
  17. 17.
    Hollingsworth, DR, Vaucher, Y, Yamamoto, TR, Diabetes in pregnancy in Mexican Americans,Diabetes Care, 14:695–705, 1991.Google Scholar
  18. 18.
    U.S. Department of Health and Human Services,Healthy People 2000. National Health Promotion and Disease Prevention Objectives, Washington, D.C., Public Health Service, 1991.Google Scholar

Copyright information

© Human Sciences Press, Inc 1994

Authors and Affiliations

  • Sylvia Guendelman
    • 3
  • Gilberto Chavez
    • 1
  • Roberta Christianson
    • 2
  1. 1.California Department of Health Services, Pregnancy and Infant Health BranchUSA
  2. 2.Child Health and Development Studies Unit in BerkeleyBerkeleyUSA
  3. 3.Maternal and Child Health Program, School of Public HealthUniversity of California, BerkeleyBerkeley

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