Differences in caesarean delivery and neonatal outcomes among women of migrant origin in Finland: A population‐based study

Abstract

Background: In Finland, limited information is available on neonatal disparities among women of migrant origin.Objective: This study investigated differences in caesarean delivery and neonatal outcomes between women of migrant origin and Finnish women in Finland. Methods:The study was based on nationwide data from the Medical Birth Register of Finland. Our study included information on the most recent singleton birth of women delivering between January 2004 and December 2014 (N = 382 233). Women were classified into nine regional categories based on their country of origin. Generalized linear models were used to describe associations between country of origin and pregnancy outcomes adjusted for maternal age, socio-economic status, pre-pregnancy body mass index, parity, marital status, smoking during pregnancy, and delivery year.Finnish women were the reference group.Results: Among the study population, almost 92% of women were of Finnish origin; the remaining 8% were of migrant origin. Among the migrant women, those of Russian/former USSR origin were the largest group (n = 11 994); the smallest group was women of Latin American/Caribbean origin (n = 739). Compared with Finnish women, women of sub-Saharan African, South Asian, and East Asian origin were at greater risk of emergency caesarean delivery, preterm birth, low birthweight, and lower five-minute Apgar scores for newborns. Latin American/Caribbean-origin women were at increased risk of both elective and emergency caesarean delivery and lower five-minute Apgar scores compared with Finnish women. Women of Russian/ former USSR origin overall had a lower risk of caesarean delivery and poor neonatal outcomes compared with Finnish women. Conclusions:We identified sub-Saharan African, South Asian, and East Asian women as higher-risk groups, and women from Russia/former USSR as a lower-risk group, for emergency caesarean delivery and poor neonatal outcome compared with Finnish women. More research is needed to identify the reasons for these differences by country of origin in Finland. K E Y W O R D Scaesarean delivery, Finland, migrants, neonatal outcomes | 13 BASTOLA eT AL.

Hypertensive disorders of pregnancy among women of migrant origin in Finland: A population‐based study

“…The findings of the present study are in line with the findings of our previous study that was based on the same data 22 . In that study, we found that women of Sub‐Saharan African origin had higher risks for emergency cesarean, pre‐term birth, low birthweight, lower Apgar score and neonatal intensive unit care for newborns compared with women of Finnish origin.…”

“…So, when they migrate, they carry health benefits compared with the average person in their country of origin. However, the healthy migrant effect may not explain the lower risk of HDP among women of migrant origin because some of these migrant origin groups also have an increased risk of several other adverse pregnancy outcomes such as gestational diabetes mellitus, emergency cesarean delivery, pre‐term birth and low birthweight 21,22 . It is likely that a variety of genetic and lifestyle factors play a significant role for HDP.…”

Challenges in migrant women’s maternity care in a high‐income country: A population‐based cohort study of maternal and perinatal outcomes

“…[6][7][8][9][10][11][12][13][14] However, the results of previous studies have been inconsistent regarding mode of birth, 7,8,10,12,13,15 maternal outcomes 8,10,11 and interventions, 7,15 reflecting heterogeneous study populations, designs and exposure group definitions. Theories regarding better/adverse perinatal outcomes include the healthy migrant effect, 12 socioeconomic disadvantage, 7,8,[10][11][12]16 suboptimal use or access to care, [7][8][9]11,13,16 underlying conditions in the mother 7,10,12,15,16 and the stress of migration. 11,16 Despite increasing global attention to migrants' health, 17 there is limited knowledge on the perinatal health of migrant women in…”

“…Increased risks of adverse perinatal outcomes have been reported among migrant women in the Nordic countries compared with the host population. 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 However, the results of previous studies have been inconsistent regarding mode of birth, 7 , 8 , 10 , 12 , 13 , 15 maternal outcomes 8 , 10 , 11 and interventions, 7 , 15 reflecting heterogeneous study populations, designs and exposure group definitions. Theories regarding better/adverse perinatal outcomes include the healthy migrant effect, 12 socioeconomic disadvantage, 7 , 8 , 10 , 11 , 12 , 16 suboptimal use or access to care, 7 , 8 , 9 , 11 , 13 , 16 underlying conditions in the mother 7 , 10 , 12 , 15 , 16 and the stress of migration.…”

Association between Maternal Origin, Pre-Pregnancy Body Mass Index and Caesarean Section: A Nation-Wide Registry Study

“…While previous studies have estimated the association between maternal origin and elective and emergency caesarean section in different populations [ 12 , 31 , 32 ], few other studies have examined how pre-pregnancy BMI influences the association among migrant women. Normal weight women have been shown to have a lower risk of both elective and emergency CS compared to women with overweight and obesity [ 33 ].…”