Maternal and Paternal Birthplace and Risk of Stillbirth

Bartsch, Emily; Park, Alison L.; Pulver, Ariel; Urquia, Marcelo L.; Ray, Joel G.

doi:10.1016/s1701-2163(15)30281-4

Cited by 18 publications

(29 citation statements)

References 30 publications

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“…Our results are largely in keeping with findings from previous studies . The protective effects on adverse perinatal morbidity outcomes generally observed among infants of Chinese‐born mothers may relate to the healthy immigrant effect; that is, wealthier and healthier individuals are more likely to immigrate to the developed countries resulting in lower perinatal risks.…”

Section: Commentsupporting

confidence: 90%

Adverse perinatal outcomes in immigrants: A ten‐year population‐based observational study and assessment of growth charts

Choi

Henry

Hilder

et al. 2019

Paediatric Perinatal Epid

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A mother's country of birth is associated with the risk to poorer newborn outcomes -study of over 2 million babies born in Australia reveals (Figure 3). AbstractBackground: Maternity populations are becoming increasingly multiethnic.Conflicting findings exist regarding the risk of adverse perinatal outcomes among immigrant mothers from different world regions and which growth charts are most appropriate for identifying the risk of adverse outcomes.Objective: To evaluate whether infant mortality and morbidity, and the categorisation of infants as small for gestational age or large for gestational age (SGA or LGA) vary by maternal country of birth, and to assess whether the choice of growth chart alters the risk of adverse outcomes in infants categorised as SGA and LGA. Methods:A population cohort of 601 299 singleton infants born in Australia to immigrant mothers was compared with 1.7 million infants born to Australian-born mothers, 2004-2013. Infants were categorised as SGA and LGA according to a descriptive Australian population-based birthweight chart (Australia-2012 reference) and the prescriptive INTERGROWTH-21st growth standard. Propensity score reweighting was used for the analysis.Results: Compared to Australian-born infants, infants of mothers from Africa, Philippines, India, other Asia countries, and the Middle East had between 15.4% and 48.1% elevated risk for stillbirth, preterm delivery, or low Apgar score. The association between SGA and LGA and perinatal mortality varied markedly by growth chart and country of birth. Notably, SGA infants from African-born mothers had a relative risk of perinatal mortality of 6.1 (95% CI 4.3, 6.7) and 17.3 (95% CI 12.0, 25.0) by the descriptive and prescriptive charts, respectively.LGA infants born to Australian-born mothers were associated with a 10% elevated risk of perinatal mortality by the descriptive chart compared to a 15% risk reduction by the prescriptive chart. Conclusions:Country-of-birth-specific variations are becoming increasingly important for providing ethnically appropriate and safe maternity care. Our findings highlight significant variations in risk of adverse perinatal outcomes in immigrant subgroups, and demonstrate how the choice of growth chart alters the quantification of risk associated with being born SGA or LGA.A commentary based on this article appears on pages 433-435

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Section: Commentsupporting

confidence: 90%

Adverse perinatal outcomes in immigrants: A ten‐year population‐based observational study and assessment of growth charts

Choi

Henry

Hilder

et al. 2019

Paediatric Perinatal Epid

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“…We excluded stillbirths, as information on parental place of birth is missing for 12% of records. 11 As all records were deidentified, a given woman may have contributed more than one birth during the study period, but we adjusted for parity, as described below. All pregnancy and newborn care is universally covered under Ontario’s Health Insurance Plan.…”

Section: Methodsmentioning

confidence: 99%

Concomitant preterm birth and severe small-for-gestational age birth weight among infants of immigrant mothers in Ontario originating from the Philippines and East Asia: a population-based study

et al. 2017

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ObjectivesWomen from the Philippines form one of the largest immigrant groups to North America. Their newborns experience higher rates of preterm birth (PTB), and separately, small-for-gestational age (SGA) birth weight, compared with other East Asians. It is not known if Filipino women are at elevated risk of concomitant PTB and severe SGA (PTB–SGA), a pathological state likely reflective of placental dysfunction and neonatal morbidity.MethodsWe conducted a population-based study of all singleton or twin live births in Ontario, from 2002 to 2011, among immigrant mothers from the Philippines (n=27 946), Vietnam (n=15 297), Hong Kong (n=5618), South Korea (n=5148) and China (n=42 517). We used modified Poisson regression to generate relative risks (RR) of PTB-SGA, defined as a birth <37 weeks’ gestation and a birth weight <5th percentile. RRs were adjusted for maternal age, parity, marital status, income quintile, infant sex and twin births.ResultsRelative to mothers from China (2.3 per 1000), the rate of PTB–SGA was significantly higher among infants of mothers from the Philippines (6.5 per 1000; RR 2.91, 95% CI 2.27 to 3.73), and those from Vietnam (3.7 per 1000; RR 1.68, 95% CI 1.21 to 2.34). The RR of PTB–SGA was not higher for infants of mothers from Hong Kong or South Korea.InterpretationAmong infants born to immigrant women from five East Asian birthplaces, the risk of PTB–SGA was highest among those from the Philippines. These women and their fetuses may require additional monitoring and interventions.

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“…Intermarriage is considered one of the most powerful indicators of integration [45]. Having an Australian-born partner may result in more interaction within the community, competency in English, as well as familiarity with the health system when navigating pregnancy care [18,46].…”

Section: Plos Onementioning

confidence: 99%

The influence of acculturation on the risk of stillbirth in migrant women residing in Western Australia

2020

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Objective To investigate the influence of acculturation, demonstrated by age on arrival, length of residence, interpreter use and having an Australian-born partner, on disparities observed in the risk of stillbirth between migrant and Australian-born populations in Western Australia (WA). Methods A retrospective cohort study using linked administrative health data for all non-Indigenous births in WA from 2005-2013 was performed. Logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Adjusted odds ratios (aOR) for stillbirth in migrants from six ethnicities of white, Asian, Indian, African, Māori, and 'other', with different levels of acculturation, were compared with Australian-born women using multivariable logistic regression analysis and marital status, maternal age group, socioeconomic status, parity, plurality, previous stillbirth, any medical conditions, any pregnancy complications, sex of baby, and smoking during pregnancy as the covariates. Results From all births studied, 172,571 (66%) were to Australian-born women and 88,395 (34%) to migrant women. Women from African, Indian and Asian backgrounds who gave birth in the first two years after arrival in Australia experienced the highest risk of stillbirth (aOR 3.32; 95% CI 1.70-6.47, aOR 2.71; 95% CI 1.58-4.65, aOR 1.93; 95% CI 1.21-3.05 respectively) compared with Australian-born women. This association attenuated with an increase in the length of residence in Asian and Indian women, but the risk of stillbirth remained elevated in African women after five years of residence (aOR 1.96 [1.10-3.49]). Interpreter use and an Australian-born partner were associated with 56% and 20% lower odds of stillbirth in migrants (p<0.05), respectively.

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Maternal and Paternal Birthplace and Risk of Stillbirth

Cited by 18 publications

References 30 publications

Adverse perinatal outcomes in immigrants: A ten‐year population‐based observational study and assessment of growth charts

Adverse perinatal outcomes in immigrants: A ten‐year population‐based observational study and assessment of growth charts

Concomitant preterm birth and severe small-for-gestational age birth weight among infants of immigrant mothers in Ontario originating from the Philippines and East Asia: a population-based study

The influence of acculturation on the risk of stillbirth in migrant women residing in Western Australia

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