The relationships among acculturation, body mass index, depression, and interleukin 1-receptor antagonist in Hispanic pregnant women.

OBJECTIVE The purpose of this study was to determine relationships between acculturation, body mass index (BMI), and depressive symptoms with the Interleukin 1-mediated inflammatory response marker IL-1RA in pregnant Hispanic women at 22-24 weeks gestation. DESIGN An observational, prospective design with data collected at 22-24 weeks gestation. SETTING Public prenatal health clinics and private physician practices in central and south Texas serving low-income women. MAIN OUTCOME MEASURES Body mass index (BMI), depression scores on the Center for Epidemiological Studies of Depression (CES-D), years in the United States, the Language Proficiency Scale (LPS), and Interleukin 1 receptor antagonist levels (IL-1RA). RESULTS The longer the Hispanic women were in the United States, the higher the IL-1RA levels in plasma (F=4.55; P=.002). IL-1RA plasma levels were significantly different between low and normal BMI vs overweight and obese categories of BMI (F=8.54; P<.001). IL-1RA levels were significantly higher between those women who had high scores for depressive symptoms on the CES-D (using a cut off of 20) and those who had scores less than 20 (t-value=-2.41; P=.018). In structural equation modeling, years in the United States significantly positively predicted increased depressive symptoms, increased BMI, and increased IL-1RA levels with a good model fit. CONCLUSIONS We found that increasing years of residency in the United States is associated with the elevated inflammatory marker IL-1RA, and increased BMI. Increased depressive symptoms also predict IL-1RA levels among Hispanic women at 22-24 weeks of pregnancy. The significance of these findings is discussed in relationship to the development and course of disease.