Women Who Move To The UK Pick Up Poor Maternal Behaviors

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Main Category: Pregnancy / Obstetrics
Also Included In: Smoking / Quit Smoking;  Public Health;  Alcohol / Addiction / Illegal Drugs
Article Date: 10 Apr 2008 - 16:00 PDT

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A study published online at bmj.com reports that the maternal health behaviors of women worsen after immigrating to the UK. Ethnic minority women who stay in the UK for longer durations are more likely to smoke during pregnancy and give up breastfeeding early.

As immigration to the UK has increased over the last 50 years, there has been more interest in studying the behaviors of ethnic minority groups. For example, research has indicated that women from ethnic minority groups are more likely to breast feed than British/Irish white women. However, there are no studies that have assessed cultural differences in how pregnant women treat alcohol and tobacco. Also missing in the literature are studies that examine whether the health behaviors of women change with acculturation (the adopting of behaviors from the new dominant culture and losing of behaviors from the original culture).

To address this gap in the literature, researchers from the UCL Institute of Child Health in London studied a sample of 8,588 mothers with singleton children - 6,478 British/Irish white mothers and 2,110 mothers from ethnic minority groups. The mothers were interviewed about maternal health behaviors, generational status, and how long they have resided in the UK. The behavioral comparisons focused on smoking and alcohol consumption before birth and the initiation and duration of breast feeding after birth.

The results showed that mothers from ethnic minority groups were:

• Less likely to smoke than British/Irish mothers (15% vs. 37%)
• Less likely to consume alcohol during pregnancy (14% vs. 37%)
• More likely to start breast feeding (86% vs. 69%)
• More likely to breast feed for at least four months (40% vs. 27%).

When focusing on the mothers from ethnic minority groups, the researchers noticed that first and second generation mothers were more likely to smoke during pregnancy and less likely to start and continue breast feeding than more recent immigrants. That is, they were more likely to exhibit behaviors of the British/Irish mothers.

Strikingly, a five year increase in time spent in the UK was associated with a 32% increase in the likelihood of smoking during pregnancy and a 5% decrease in the likelihood of breast feeding for at least four months. These findings indicate the acculturation of ethnic minority populations.

The results, "have public health implications for countries with large immigrant populations", write the authors. Health professionals, according to the authors, should not use a woman's ethnicity to make assumptions regarding health behaviors, for it could lead to missing many women who engage in risky behaviors.

"National policies should promote beneficial health behaviours among all mothers. Recommendations have been modified since the cohort children were born. Mothers in England are now recommended to avoid all alcohol during pregnancy and breast feed exclusively for at least six months," conclude the authors.

An accompanying editorial written by Krista M Perreira (Carolina Population Center and Department of Public Policy, University of North Carolina, NC) adds: "As the number of international migrants continues to increase worldwide, smoking and alcohol consumption patterns among women in developing countries will have consequences for medical providers throughout Europe and North America."

She concludes by noting: "The research by Hawkins and colleagues is an important first step in developing programmes and policies that promote the health of immigrant women and their children."

Influence of moving to the UK on maternal health behaviours: prospective cohort study
Summer Sherburne Hawkins, Kate Lamb, Tim J Cole, Catherine Law, the Millennium Cohort Study Child Health Group
BMJ. (2008).
doi:10.1136/bmj.39532.688877.25
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Written by: Peter M Crosta
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