Influence of moving to the UK on maternal health behaviours: prospective cohort study
BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39532.688877.25 (Published 08 May 2008) Cite this as: BMJ 2008;336:1052
- Summer Sherburne Hawkins, research fellow,
- Kate Lamb, MSc student,
- Tim J Cole, professor,
- Catherine Law, professor
- the Millennium Cohort Study Child Health Group
- 1Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London WC1N 1EH
- Correspondence to: S S Hawkins s.hawkins{at}ich.ucl.ac.uk
- Accepted 11 March 2008
Abstract
Objective To compare health behaviours during pregnancy (smoking and alcohol consumption) and after birth (initiation and duration of breast feeding) between British/Irish white mothers and mothers from ethnic minority groups; and, in mothers from ethnic minority groups, to examine whether indicators of acculturation (generational status, language spoken at home, length of residency in the United Kingdom) were associated with these health behaviours.
Design Prospective nationally representative cohort study.
Setting England.
Participants 6478 British/Irish white mothers and 2110 mothers from ethnic minority groups.
Main outcome measures Any smoking during pregnancy; any alcohol consumption during pregnancy; initiation of breast feeding; breast feeding for at least four months.
Results Compared with British/Irish white mothers, mothers from ethnic minority groups were less likely to smoke (15% v 37%) or consume alcohol (14% v 37%) during pregnancy but more likely to initiate breast feeding (86% v 69%) and breast feed for at least four months (40% v 27%). Among mothers from ethnic minority groups, first and second generation mothers were more likely to smoke during pregnancy (odds ratio 3.85, 95% confidence interval 2.50 to 5.93, and 4.70, 2.49 to 8.90, respectively), less likely to initiate breast feeding (0.92, 0.88 to 0.97, and 0.86, 0.75 to 0.99), and less likely to breast feed for at least four months (0.72, 0.62 to 0.83, and 0.52, 0.30 to 0.89) than immigrants, after adjustment for sociodemographic characteristics. There were no consistent differences in alcohol consumption. Among immigrants, for every additional five years spent in the UK the likelihood of mothers smoking during pregnancy increased by 31% (4% to 66%) and they were 5% (0% to 10%) less likely to breast feed for at least four months.
Conclusions After immigration, maternal health behaviours worsen with length of residency in the UK. Health professionals should not underestimate women’s likelihood of engaging in risky health behaviours because of their ethnicity.
Footnotes
We thank all of the millennium cohort study families for their cooperation, and the study team at the Centre for Longitudinal Studies, Institute of Education, University of London.
Contributors: SSH and CL contributed to the conception, study design, interpretation of the data, and first draft of the article. SSH, KL, and TJC contributed to the analysis. TJC and KL also contributed to the interpretation of the data and drafting of the article. All authors approved the final version. SSH is guarantor. Other members of the millennium cohort study child health group (Carol Dezateux, Catherine Peckham, Jugnoo Rahi, Helen Bedford, Phillippa Cumberland, Lucy Jane Griffiths, Anna Pearce, Suzanne Bartington) also contributed to this work.
Funding: The millennium cohort study is funded by grants to Heather Joshi, director of the study, from the ESRC and a consortium of government funders. SSH is funded through a Department of Health Researcher Development Award. KL received funding from the North London Deanery. TJC is funded through an MRC programme grant (G9827821). This work was undertaken at GOSH/UCL Institute of Child Health, which received a proportion of funding from the Department of Health’s NIHR Biomedical Research Centres funding scheme.
Competing interests: None declared.
Ethical approval: The millennium cohort study received ethical approval from the South West and London multi-centre research ethics committees; no additional approval was required for this study.
Provenance and peer review: Not commissioned; externally peer reviewed.