A Systematic Review and Meta-Analysis of the Risk of Stillbirth, Perinatal and Neonatal Mortality in Immigrant Women

Behboudi‐Gandevani, Samira; Panahi, Mohammad Hossein; Mardani, Abbas; Kymre, Ingjerd Gåre; Paal, Piret; Vaismoradi, Mojtaba

doi:10.3389/ijph.2022.1604479

Cited by 10 publications

(7 citation statements)

References 78 publications

(136 reference statements)

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“…Some studies reported that the perinatal health of immigrants were equal or better compared to the native origin population. In contrast, some studies showed that the risk of adverse pregnancy outcomes were poorer than women in the host country [ 6 7 8 9 10 11 ]. Given the lack of conclusive evidence, the aim of this systematic review and meta-analysis was to investigate the risk of adverse maternal and neonatal outcomes in immigrant women compared to native-origin women in the host country.…”

Section: Introductionmentioning

confidence: 99%

Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis

Behboudi‐Gandevani

Panahi

Mardani

et al. 2022

Annals of Global Health

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Background: Disparities in health outcomes between immigrant and native-origin populations, particularly pregnant women, pose significant challenges to healthcare systems. The aim of this systematic-review and meta-analysis was to investigate the risk of adverse pregnancy outcomes among immigrant-women compared to native-origin women in the host country.Methods: PubMed (including MEDLINE), Scopus, and Web of Science were searched to retrieve studies published in English language up to September 2020. All observational studies examining the prevalence of at least one of the short-term single pregnancy outcomes for immigrants who crossed international borders compared to native-origin pregnant population were included. The meta-prop method was used for the pooledestimation of adverse pregnancy-outcomes' prevalence. For pool-effect estimates, the association between the immigration-status and outcomes of interest, the randomeffects model was applied using the model described by DerSimonian and Laird. I 2 statistic was used to assess heterogeneity. The publication bias was assessed using the Harbord-test. Meta-regression was performed to explore the effect of geographical region as the heterogeneity source.Findings: This review involved 11 320 674 pregnant women with an immigrationbackground and 56 102 698 pregnant women as the native-origin population. The risk of emergency cesarean section (Pooled-OR = 1.1, 95%CI = 1.0-1.2), shoulder dystocia (Pooled-OR = 1.1, 95%CI = 1.0-1.3), gestational diabetes mellites (Pooled-OR = 1.4, 95%CI = 1.2-1.6), small for gestational age (Pooled-OR=1.3, 95%CI = 1.1-0.4), 5-min Apgar less than 7 (Pooled-OR = 1.2, 95%CI = 1.0-1.3) and oligohydramnios (Pooled-OR = 1.8, 95%CI = 1.0-3.3) in the immigrant women were significantly higher than those with the native origin background. The immigrant women had a lower risk of labor induction (Pooled-OR = *Author affiliations can be found in the back matter of this article 2 Behboudi-Gandevani et al.

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Section: Introductionmentioning

confidence: 99%

Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis

Behboudi‐Gandevani

Panahi

Mardani

et al. 2022

Annals of Global Health

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“…Immigrants may have a different health trajectory and pregnancy outcomes than nonimmigrants . Accordingly, an additional analysis was completed for the corresponding main model of any upward income mobility and SMM-M or SNM-M.…”

Section: Methodsmentioning

confidence: 99%

“…Immigrants may have a different health trajectory and pregnancy outcomes than nonimmigrants. 22 , 23 , 44 , 45 Accordingly, an additional analysis was completed for the corresponding main model of any upward income mobility and SMM-M or SNM-M. Therein, the interaction term of “neighborhood income mobility between births and immigrant status” was added to each respective model.…”

Section: Methodsmentioning

confidence: 99%

Neighborhood Income Mobility and Risk of Neonatal and Maternal Morbidity

et al. 2023

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ImportanceResiding in a low-income neighborhood is generally associated with worse pregnancy outcomes. It is not known if moving from a low- to higher-income area between 2 pregnancies alters the risk of adverse birth outcomes in the subsequent birth compared with women who remain in low-income areas for both births.ObjectiveTo compare the risk of adverse maternal and newborn outcomes among women who achieved upward area-level income mobility vs those who did not.Design, Setting, and ParticipantsThis population-based cohort study was completed in Ontario, Canada, from 2002 to 2019, where there is universal health care. Included were all nulliparous women with a first-time singleton birth at 20 to 42 weeks’ gestation, each residing in a low-income urban neighborhood at the time of the first birth. All women were then assessed at their second birth. Statistical analysis was conducted from August 2022 to April 2023.ExposureMovement from a lowest-income quintile (Q1) neighborhood to any higher-income quintile neighborhood (Q2-Q5) between the first and second birth.Main Outcomes and MeasuresThe maternal outcome was severe maternal morbidity or mortality (SMM-M) at the second birth hospitalization or up to 42 days post partum. The primary perinatal outcome was severe neonatal morbidity or mortality (SNM-M) within 27 days of the second birth. Relative risks (aRR) and absolute risk differences (aARD) were estimated by adjusting for maternal and infant characteristics.ResultsA total of 42 208 (44.1%) women (mean [SD] age at second birth, 30.0 [5.2] years) experienced upward area-level income mobility, and 53 409 (55.9%) women (age at second birth, 29.0 [5.4] years) remained in income Q1 between births. Relative to women who remained in income Q1 between births, those with upward mobility had a lower associated risk of SMM-M (12.0 vs 13.3 per 1000 births), with an aRR of 0.86 (95% CI, 0.78 to 0.93) and aARD of −2.09 per 1000 (95% CI, −3.1 to −0.9 per 1000 ). Likewise, their newborns experienced lower respective rates of SNM-M (48.0 vs 50.9 per 1000 live births), with an aRR of 0.91 (95% CI, 0.87 to 0.95) and aARD of −4.7 per 1000 (95% CI, −6.8 to −2.6 per 1000).Conclusions and RelevanceIn this cohort study of nulliparous women living in low-income areas, those who moved to a higher-income area between births experienced less morbidity and death in their second pregnancy, as did their newborns, compared with those who remained in low-income areas between births. Research is needed to determine whether financial incentives or enhancement of neighborhood factors can reduce adverse maternal and perinatal outcomes.

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“…Foreign-born women living in Sweden constitute a heterogeneous population with different experiences, backgrounds, health needs, and health-related behaviors. Moreover, foreign-born women living in Sweden are reported to experience more adverse birth outcomes 12,13 , higher levels of fear of birth 14,15 , and stillbirth 16 .…”

Section: Introductionmentioning

confidence: 99%

Foreign-born women rated medical and emotional aspects of postnatal care higher than women born in Sweden: A quantitative comparative study

Hildingsson,

Parment,

Öhrn

et al. 2023

Eur J Midwifery

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INTRODUCTION Although high-quality postnatal care provides information and recognizes women's personal and cultural contexts, foreign-born women are more exposed to poor health and adverse birth outcomes. The aim of this study was to compare the length and model of postnatal care, along with the content of care, between foreign-born and nativeborn women living in Sweden. Another aim was to explore factors associated with being very satisfied with various aspects of postnatal care. METHODS This was a descriptive cross-sectional study of 483 postnatal women in two Swedish hospitals in 2017. Women completed a questionnaire comprising background data, pregnancy and birth related variables and the Early Postnatal Questionnaire. Data were analyzed using descriptive statistics, analysis of variance and multivariate logistic regression analyses. RESULTS Foreign-born women were more likely to have a shorter (<24 h) or longer (>48 h) length of postnatal stay than women born in Sweden. No differences in birth outcomes emerged between the two groups. Foreign-born women rated the medical (OR=1.77; 95% CI: 1.04-3.03) and emotional (OR=2.0; 95% CI: 1.17-3.40) aspects of postnatal care as being more important than Swedish-born women did. The most important aspect of overall satisfaction was the content of care, and the subscale Caring Relationship (AOR=8.15; 95% CI: 4.87-14.62) outscored all other aspects. CONCLUSIONS Important factors of satisfactory experiences with postnatal care in a Swedish context were receiving information, professional care, and a hospital environment that facilitates recovery after labor and birth. Culturally sensitive and individualized postnatal care with continuity should therefore be prioritized.

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A Systematic Review and Meta-Analysis of the Risk of Stillbirth, Perinatal and Neonatal Mortality in Immigrant Women

Cited by 10 publications

References 78 publications

Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis

Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis

Neighborhood Income Mobility and Risk of Neonatal and Maternal Morbidity

Foreign-born women rated medical and emotional aspects of postnatal care higher than women born in Sweden: A quantitative comparative study

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