Association between interpreter use and small for gestational age infants.
Carrie A Sibbald1, Amy Godecker1, Erin J Bailey1
1Department of Obstetrics and Gynecology, University of Wisconsin, Madison, WI.
American Journal of Obstetrics & Gynecology MFM
|September 16, 2024
Summary
Using interpreter services in obstetrics is linked to fewer cases of infants born small for gestational age. This highlights the importance of language access for improving pregnancy outcomes and maternal health equity.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Health
- Health Services Research
Background:
- Limited English proficiency is linked to poorer health outcomes, irrespective of health literacy.
- Interpreter services are known to improve patient satisfaction and mitigate language barriers.
- The impact of English proficiency on obstetric and neonatal outcomes remains understudied.
Purpose of the Study:
- To investigate if low English proficiency, proxied by interpreter use, is an independent risk factor for small for gestational age (SGA) infants.
- To test the hypothesis that communication challenges and discrimination associated with non-English primary speakers increase high-risk pregnancies.
- To determine the association between the need for interpreter services and the incidence of SGA.
Main Methods:
- Retrospective cohort study (2016-2021) including singleton live births ≥ 21 weeks gestation.
- Primary outcome: rate of small for gestational age (SGA), defined as birthweight < 10th percentile using the 2018 Fenton growth curve.
- Multivariable logistic regression analysis was used to control for confounding variables.
Main Results:
- The study included 26,260 patients; 6.3% utilized interpreter services, predominantly Hispanic patients (58.0%).
- Unadjusted analysis showed no significant difference in SGA rates between interpreter users (6.4%) and non-users (6.6%).
- Adjusted analysis revealed that interpreter service use was associated with decreased odds of SGA (aOR 0.67, 95% CI 0.53-0.84).
Conclusions:
- Interpreter use is associated with a lower incidence of small for gestational age infants after controlling for patient characteristics and social determinants of health.
- Recognizing demographic risk factors and providing resources like interpreter services may improve obstetric and neonatal outcomes.
- Further research is needed to fully understand this association and its implications for maternal-fetal medicine.
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