Is the socioeconomic status of immigrant mothers in Brussels relevant to predict their risk of adverse pregnancy outcomes?

Abstract

BackgroundUnderstanding and tackling perinatal health inequities in industrialized countries requires analysing the socioeconomic determinants of adverse pregnancy outcomes among immigrant populations. Studies show that among certain migrant groups, education is not associated with adverse pregnancy outcomes. We aim to extend this analysis to further dimensions of socioeconomic status (SES) and to other settings. The objective of this study is to identify sociodemographic characteristics associated with adverse pregnancy outcomes, according to the origin of mothers residing in Brussels.MethodsWe analysed all singleton live births in Brussels between 2005 and 2010 (n = 97,844). The data arise from the linkage between three administrative databases. Four groups of women were included according to their place of birth: Belgium, EU, North Africa, and Sub-Saharan Africa. For each group, logistic regression was carried out to estimate the odds ratios of low birthweight (LBW) and small for gestational age (SGA) according to SES indicators (household income, maternal employment status, maternal education) and single parenthood.ResultsThree key findings emerge from this study: 1) 25% of children were born into a household under the poverty threshold. This proportion was much higher for mothers born outside of the EU. 2) For North African immigrants, SES indicators didn’t influence the pregnancy outcomes, whereas their risk of LBW increased with single parenthood. 3) For Sub-Saharan Africans the risk of LBW increased with low household income.ConclusionIn a region where immigrant mothers are at high poverty risk, we observe a classic social gradient in perinatal outcomes only for mothers born in Belgium or the EU. In the other groups, SES influences perinatal outcomes less systematically. To develop interventions to reduce inequities from birth, it’s important to identify the determinants of perinatal health among immigrants and to understand the underlying mechanisms in different contexts.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-2043-3) contains supplementary material, which is available to authorized users.

Impact of Socio-economic Status on Low Birthweight: Decomposing the Differences Between Natives and Immigrants in Spain

“…For example, Acevedo-Garcia et al [11] showed that foreign born status was associated with high odds of low birth weight among highly educated mothers and lower odds among mothers with low educational attainment. Similar patterns were observed for specific origins in Belgium [16].…”

“…This regularity is referred to in the literature as the healthy immigrant effect [12,13] Although the healthy immigrant effect depends strongly on specific outcomes and the origins of the immigrants, a number of studies showed that immigrant status played a protective role in gropus which are particularly exposed to adverse socio-economic penalties. Specifically, some immigrant groups exhibited more favorable perinatal health outcomes when compared to natives and other immigrant populations even if they are more socioeconomically vulnerable [14][15][16]. In addition, there is evidence that the protective effect of immigrant status regarding specific indicators of perinatal healts variates across SES categories within the same immigrant groups.…”

Socioeconomic status of pregnancy outcomes in Chongqing, Southwest China

“…Some studies have shown that low SES in pregnant women can increase the risk of adverse pregnancy outcomes such as GDM, PTB, LBW and SGA [2][3][4][5][6][7]. However, others have suggested that SES indicators have little influence on pregnancy outcomes [7][8][9][10][11]. These contradictory findings shows that SES effects on pregnancy outcomes varied depending on pregnancy complications, countries, regions, races, especially on the SES indicators being examined.…”

“…Most researchers have used a single SES indicator to reflect an individual's SES or used some SES indicators as proxies for others [13]. For example, pregnant women with lower education were more likely to suffer from GDM, PTB, LBW and SGA than those with higher education [4,5,7], whereas SES (education, occupation, and income) didn't influence the pregnancy outcomes for North African immigrants [11]. Others have investigated SES by using the community relevance information such as the household and context where a person resides [12,13].…”

Socioeconomic status of pregnancy outcomes in Chongqing, Southwest China

“…Some studies have shown that low SES in pregnant women can increase the risk of adverse pregnancy outcomes such as GDM, PTB, LBW, and SGA [2][3][4][5][6][7]. However, others have suggested that SES indicators have little influence on pregnancy outcomes [7][8][9][10][11]. These contradictory findings may reflect differences between countries, regions, or races.…”