Maternal Emotional Distress Following the Birth of a Preterm Baby: The Case of Bedouin Mothers Living in Southern Israel

Mothers of preterm infants are at higher risk for postpartum emotional distress (PPED). In this study, we investigated PPED among Bedouin mothers, an ethnic minority group living in Israel. Our aim was to understand how maternal acculturation style and birth order were related to mothers’ PPED following a premature birth. Three hundred twenty-one Bedouin mothers and their babies (preterm: n = 66; full-term: n = 255) participated in the study. Data were collected in the maternity ward and the NICU (Neonatal Intensive Care Unit) of a large general hospital in Southern Israel providing medical care to all populations in the southern region. Mothers completed questionnaires on maternal postpartum depression and anxiety. Additionally, maternal acculturation style was assessed using the acculturation questionnaire and information on child birth order. Mothers of preterm infants indicated having more symptoms of PPED than mothers of full-term infants. Additionally, both maternal acculturation style as well as birth order (i.e., whether the preterm was first- or later-born) were found to act as moderators in the link between prematurity and PPED. Specifically, we found that among the preterm group, low levels of Westernized acculturation style and the birth of a preterm infant who was later-born predicted higher levels of PPED. Our findings indicate that ethnicity, acculturation, and birth order are important variables that need to be considered when studying PPED and premature birth. Results highlight the fact that mothers from an ethnic minority group who have had a premature birth are at higher risk for experiencing PPED. However, individual differences emerged when examining maternal acculturation style and birth order. Culturally—informed clinical implications are proposed.

A Comparison of Weight-Related Behaviors of Hispanic Mothers and Children by Acculturation Level

Hispanic mothers and children in the United States experience a high prevalence of obesity, which may be affected by maternal acculturation level. Little is known about the association of acculturation on weight-related behaviors. This study describes differences in weight-related behaviors by acculturation level of Hispanic mothers residing in the U.S. and compares them to behaviors of White mothers. Acculturation level was determined using personal acculturation and acculturation environment variables. Cluster analysis of acculturation variables identified three groups of Hispanic mothers: low personal and environmental acculturation (n = 46), high personal and low environmental acculturation (n = 65), and high personal and environmental acculturation (n = 38). Results indicate that, compared to White mothers (n = 340), the least acculturated cluster of Hispanic mothers tended to model physical activity less often and the most acculturated exerted more pressure on children to eat. Mothers in the least acculturated cluster tended to rate children’s health status lower, indicate that children had greater fruit juice and less milk intakes, have more meals in locations associated with less healthy meals, and have the least space and supports for physical activity. Findings highlight relationships between maternal acculturation level and weight-related behaviors and suggest strategies for helping acculturating Hispanic mothers create healthier lifestyles and home environments.

Acculturation Determines BMI Percentile and Noncore Food Intake in Hispanic Children

Hispanic children in the United States are disproportionately affected by obesity. The role of acculturation in obesity is unclear. This study examined the relation between child obesity, dietary intake, and maternal acculturation in Hispanic children. We hypothesized that children of more acculturated mothers would consume more unhealthy foods and would have higher body mass index (BMI) percentiles. A total of 209 Hispanic mothers of children aged 2–4 y (50% female, 35.3 ± 8.7 mo, BMI percentile: 73.1 ± 27.8, 30% obese, 19% overweight) were recruited for an obesity prevention/reversal study. The associations between baseline maternal acculturation [Brief Acculturation Rating Scale for Mexican Americans-II (Brief ARSMA-II)], child BMI percentile, and child diet were examined. Factor analysis of the Brief ARSMA-II in Puerto Rican mothers resulted in 2 new factors, which were named the Hispanic Orientation Score (4 items, loadings: 0.64–0.81) and U.S. Mainland Orientation Score (6 items, loadings: −0.61–0.92). In the total sample, children who consumed more noncore foods were more likely to be overweight or obese (P < 0.01). Additionally, children of mothers with greater acculturation to the United States consumed more noncore foods (P < 0.0001) and had higher BMI percentiles (P < 0.04). However, mothers with greater Hispanic acculturation served fewer noncore foods (P < 0.0001). In the Puerto Rican subgroup of mothers, Puerto Rican mothers with greater acculturation to the United States served more noncore foods (P < 0.0001), but there was no association between acculturation and child BMI percentile in this subgroup. These mothers, however, served fewer sugar-sweetened beverages (P < 0.01) compared with non-Puerto Rican mothers, and this may have negated the effect of noncore food consumption on BMI percentile. These data suggest a complex relation between acculturation, noncore food consumption, and child BMI percentile in Puerto Rican and non-Puerto Rican Hispanic children.