RESUMO
INTRODUCTION: The objective of this study was to examine correlates of ever having had a Papanicolaou (Pap) test among women who recently delivered a live infant and who resided near the US-Mexico border. METHODS: This cross-sectional study included women who delivered a live infant in Matamoros, Mexico (n = 488) and Cameron County, Texas (n = 453). Women were interviewed in the hospital before discharge between August 21 and November 9, 2005. Multivariable logistic regression was used to estimate the odds of ever having had a Pap test. RESULTS: Significantly fewer Matamoros women (62.1%) than Cameron County women (95.7%) reported ever having had a Pap test. Only 12% of Matamoros women said they received their most recent Pap test during prenatal care, compared with nearly 75% of Cameron County women. After adjusting for potential confounders, the odds of ever having had a Pap test were 7.41 times greater in Cameron County than in Matamoros (95% confidence interval, 4.07-13.48). CONCLUSION: The Healthy Border 2010 goals are to cut cervical cancer mortality by 20% to 30% in the border region. The significant difference in Pap test prevalence among our survey respondents may reflect that routine prenatal Pap testing is more common in the United States than in Mexico. Because women who are receiving prenatal care have increased interaction with health care providers, Matamoros providers may need to be educated about the need to screen for cervical cancer during this time.
Assuntos
Neoplasias do Colo do Útero/diagnóstico , Serviços de Saúde da Mulher/organização & administração , Estudos Transversais , Di-Hidroergotamina , Educação , Feminino , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Hispânico ou Latino , Humanos , México , Análise Multivariada , Teste de Papanicolaou , Parto , Gravidez , Cuidado Pré-Natal , Fatores Socioeconômicos , Texas , Esfregaço VaginalRESUMO
INTRODUCTION: The US-Mexico border region has a growing population and limited health care infrastructure. Preventive health behaviors such as breastfeeding ease the burden on this region's health care system by reducing morbidity and health care costs. We examined correlates of attempted breastfeeding before hospital discharge on each side of the US-Mexico border and within the border region. METHODS: The cross-sectional study included women who delivered a live infant in Matamoros, Tamaulipas, Mexico (n = 489), and Cameron County, Texas (n = 457), which includes Brownsville, Texas. We interviewed women before hospital discharge from August 21 through November 9, 2005. We used multivariate logistic regression to estimate the odds of attempted breastfeeding before hospital discharge in Cameron County, Texas, the municipality of Matamoros, Mexico, and the 2 communities combined. RESULTS: Prevalence of attempted breastfeeding before hospital discharge was 81.9% in Matamoros compared with 63.7% in Cameron County. After adjusting for potential confounders, the odds of attempted breastfeeding before hospital discharge were 90% higher in Matamoros than in Cameron County (adjusted odds ratio [AOR], 1.93; 95% confidence interval [CI], 1.31-2.84 for the combined model). In the 2 communities combined, odds of attempted breastfeeding before hospital discharge were higher among women who had a vaginal delivery than among women who had a cesarean delivery (AOR, 1.98; 95% CI, 1.43-2.75) and were lower among women who delivered infants with a low birth weight than among women who delivered infants with a normal birth weight (AOR, 0.26; 95% CI, 0.15-0.44). CONCLUSION: The rate of attempted breastfeeding in Matamoros was significantly higher than in Cameron County. Additional breastfeeding support and messages on the US side of the US-Mexico border are needed.
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Aleitamento Materno , Serviços de Saúde da Mulher/organização & administração , Adulto , Feminino , Política de Saúde , Hospitais , Humanos , México , Parto , Cuidado Pós-Natal , Gravidez , Cuidado Pré-Natal , Apoio Social , TexasRESUMO
INTRODUCTION: Childbearing during adolescence and young adulthood is associated with adverse effects on health and quality of life. Lowering birth rates among young women is a binational priority in the US-Mexico border region, yet baseline information about birth rates and pregnancy risk is lacking. Increased understanding of the characteristics of young women who give birth in the region will help target high-risk groups for sexual and reproductive health services. METHODS: We examined data on reproductive health characteristics collected in hospitals from 456 women aged 24 years or younger who gave birth from August 21 through November 9, 2005, in Matamoros, Tamaulipas, Mexico, and Cameron County, Texas. We calculated weighted percentages and 95% confidence intervals (CIs) for each characteristic and adjusted odds ratios (AORs) for Matamoros and Cameron County women by using multiple logistic regression techniques. RESULTS: Numbers of births per 1,000 women aged 15 to 19 years and 20 to 24 years were similar in the 2 communities (110.6 and 190.2 in Matamoros and 97.5 and 213.1 in Cameron County, respectively). Overall, 38.5% of women experienced cesarean birth. Matamoros women reported fewer prior pregnancies than did Cameron County women and were less likely to receive early prenatal care but more likely to initiate breastfeeding. Few women smoked before pregnancy, but the prevalence of alcohol use in Cameron County was more than double that of Matamoros. In both communities combined, 34.0% of women used contraception at first sexual intercourse. CONCLUSION: Despite geographic proximity, similar ethnic origin, and comparable birth outcomes, young Mexican and US women showed different health behavior patterns. Findings suggest possible pregnancy prevention and health promotion interventions.
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Cooperação Internacional , Parto , Adolescente , Distribuição por Idade , Feminino , Infecções por HIV/prevenção & controle , Humanos , México , Projetos Piloto , Gravidez , Gravidez não Desejada , Prática de Saúde Pública , Serviços de Saúde Reprodutiva , Texas , Adulto JovemRESUMO
INTRODUCTION: Routine prenatal human immunodeficiency virus (HIV) screening provides a critical opportunity to diagnose HIV infection, begin chronic care, and prevent mother-to-child transmission. However, little is known about the prevalence of prenatal HIV testing in the US-Mexico border region. We explored the correlation between prenatal HIV testing and sociodemographic, health behavior, and health exposure characteristics. METHODS: The study sample consisted of women who delivered live infants in 2005 in hospitals with more than 100 deliveries per year and resided in Matamoros, Tamaulipas, Mexico (n = 489), or Cameron County, Texas (n = 458). We examined univariate and bivariate distributions of HIV testing in Matamoros and Cameron County and quantified the difference in odds of HIV testing by using logistic regression. RESULTS: The prevalence of prenatal HIV testing varied by place of residence--57.6% in Matamoros and 94.8% in Cameron County. Women in Cameron County were significantly more likely than those in Matamoros to be tested. Marital status, education, knowledge of methods to prevent HIV transmission (adult-to-adult), discussion of HIV screening with a health care professional during prenatal care, and previous HIV testing were significantly associated with prenatal HIV testing in Matamoros, although only the latter 2 variables were significant in Cameron County. CONCLUSION: Although national policies in both the United States and Mexico recommend prenatal testing for HIV, a greater proportion of women in Cameron County were tested, compared with women in Matamoros. Efforts between Matamoros and Cameron County to improve HIV testing during pregnancy in the border region should consider correlates for testing in each community.
Assuntos
Infecções por HIV/diagnóstico , Cooperação Internacional , Cuidado Pré-Natal , Serviços de Saúde da Mulher/organização & administração , Adolescente , Adulto , Feminino , Infecções por HIV/epidemiologia , Humanos , Seguro Saúde , México , Vigilância da População , Gravidez , Prevalência , TexasRESUMO
Recent research suggests that the favorable mortality outcomes for the Mexican immigrant population in the United States may largely be attributable to selective out-migration among Mexican immigrants, resulting in artificially low recorded death rates for the Mexican-origin population. In this paper we calculate detailed age-specific infant mortality rates by maternal race/ethnicity and nativity for two important reasons: (1) it is extremely unlikely that women of Mexican origin would migrate to Mexico with newborn babies, especially if the infants were only afew hours or afew days old; and (2) more than 50% of all infant deaths in the United States occur during the first week of life, when the chances of out-migration are very small. We use concatenated data from the U.S. linked birth and infant death cohort files from 1995 to 2000, which provides us with over 20 million births and more than 150,000 infant deaths to analyze. Our results clearly show that first-hour, first-day, and first-week mortality rates among infants born in the United States to Mexican immigrant women are about 10% lower than those experienced by infants of non-Hispanic, white U.S.-born women. It is extremely unlikely that such favorable rates are artificially caused by the out-migration of Mexican-origin women and infants, as we demonstrate with a simulation exercise. Further, infants born to U.S.-born Mexican American women exhibit rates of mortality that are statistically equal to those of non-Hispanic white women during the first weeks of life and fare considerably better than infants born to non-Hispanic black women, with whom they share similar socioeconomic profiles. These patterns are all consistent with the definition of the epidemiologic paradox as originally proposed by Markides and Coreil (1986).