Maternal Origin and Risk of Neonatal and Maternal ICU Admission*

Medcalf, Karyn E.; Park, Alison L.; Vermeulen, Marian J.; Ray, Joel G.

doi:10.1097/ccm.0000000000001647

Cited by 9 publications

(10 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The overall rate of admission to intensive care during pregnancy and the postnatal period was similar to that reported in other international studies (2–4:1000) 16,36 . Studies from the Netherlands, 16 Canada, 17 and the USA, 18 conducted in local populations, similarly show an association between Black ethnicity or African or Caribbean origin and admissions to intensive care in pregnancy and the postpartum period. In common with other studies examining severe maternal morbidity in the UK we found no association with socio‐economic grouping, reflective of the universal healthcare system 37 …”

Section: Discussionsupporting

confidence: 86%

“…It is unclear to what extent this observed association is explained by differences between ethnic groups in demographic, lifestyle, pregnancy and birth factors, including co‐morbidities such as gestational diabetes and hypertension, which are more common in women of ethnic minority backgrounds 14,15 . The extent to which intensive care admissions in pregnancy and birth vary by country of origin has been examined in cohorts from the Netherlands 16 and Canada; 17 in both countries, migrant women were more likely to have admissions to intensive care. Variation by ethnic group has been examined in the USA, 18 where Black women are more likely to be admitted.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Associations between ethnicity and admission to intensive care among women giving birth: a cohort study

Jardine

Gurol‐Urganci

Harris

et al. 2021

BJOG

View full text Add to dashboard Cite

Objective To determine the association between ethnic group and likelihood of admission to intensive care in pregnancy and the postnatal period. Design Cohort study. Setting Maternity and intensive care units in England and Wales. Population or sample A total of 631 851 women who had a record of a registerable birth between 1 April 2015 and 31 March 2016 in a database used for national audit. Methods Logistic regression analyses of linked maternity and intensive care records, with multiple imputation to account for missing data. Main outcome measures Admission to intensive care in pregnancy or postnatal period to 6 weeks after birth. Results In all, 2.24 per 1000 maternities were associated with intensive care admission. Black women were more than twice as likely as women from other ethnic groups to be admitted (odds ratio [OR] 2.21, 95% CI 1.82–2.68). This association was only partially explained by demographic, lifestyle, pregnancy and birth factors (adjusted OR 1.69, 95% CI 1.37–2.09). A higher proportion of intensive care admissions in Black women were for obstetric haemorrhage than in women from other ethnic groups. Conclusions Black women have an increased risk of intensive care admission that cannot be explained by demographic, health, lifestyle, pregnancy and birth factors. Clinical and policy intervention should focus on the early identification and management of severe illness, particularly obstetric haemorrhage, in Black women, in order to reduce inequalities in intensive care admission. Tweetable abstract Black women are almost twice as likely as White women to be admitted to intensive care during pregnancy and the postpartum period; this risk remains after accounting for demographic, health, lifestyle, pregnancy and birth factors.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Associations between ethnicity and admission to intensive care among women giving birth: a cohort study

Jardine

Gurol‐Urganci

Harris

et al. 2021

BJOG

View full text Add to dashboard Cite

show abstract

“…In addition, we included socioeconomic factors in propensity score matching, such as income quintile and maternal country of origin, which also strongly predict severe maternal morbidity. 20,21 Our study included only 1 randomly selected delivery per woman, thereby avoiding any potential overestimation of the risk of infertility treatment in repeat pregnancies. 12 Another small single-centre study also showed an increased risk of severe maternal morbidity related to infertility treatment (OR 2.40, 95% CI 1.10-5.23).…”

Section: Discussionmentioning

confidence: 99%

Infertility treatment and risk of severe maternal morbidity: a propensity score–matched cohort study

Dayan

Joseph

Fell

et al. 2019

CMAJ

Self Cite

View full text Add to dashboard Cite

nfertility affects 1 in 6 Canadian couples, many of whom turn to infertility treatment. These include pharmacologic ovulation induction, intrauterine insemination, and more invasive assisted reproductive technologies, such as in vitro fertilization. In vitro fertilization often follows intense rounds of ovarian hyperstimulation, oocyte retrieval and intracytoplasmic sperm injection. 1 Assisted reproductive technology accounts for about 18 000 pregnancies in Canada each year, with 1%-4% of births conceived using infertility treatment. 2,3 Although infertility treatment improves the chances of a pregnancy among infertile couples, it may have unintended consequences for mother and newborn, such as a higher risk of preterm birth, low birth weight and cesarean delivery that are independent of age and plurality. 1,4-6 Canadian public funding programs for in vitro fertilization launched in the provinces of Quebec (2010-2015) 7 and Ontario (started in 2015 and ongoing) 8 have increased in vitro fertilization access among ethnically and socially diverse groups of women. 9 However, the effect on maternal health of infertility treatment in general-and in vitro fertilization in particular-is understudied.

show abstract

“…In our centre, immigrant women had greater odds of poor neonatal outcomes, including abnormal CTG results, CS due to abnormal CTG results and Apgar scores at 5 min. A large study conducted in Canada that included more than 800,000 births showed that the rate of neonatal ICU admissions was higher among infants born to immigrants from South Asia, Africa and the Caribbean than the infants of native Canadian mothers (RR 1.41 CI 95%, 1.36 to 1.46) [ 20 ]. Newborns admitted to the ICU may be at increased risk of neonatal mortality and have a significantly higher probability of long-term morbidity [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Human Development Index (HDI) of the maternal country of origin as a predictor of perinatal outcomes - a longitudinal study conducted in Spain

Larroca

Arévalo-Serrano

Vila

et al. 2017

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

BackgroundIn an era of worldwide population displacement, recent studies have identified strong associations between social situations and perinatal outcomes among immigrants. Little is known about the effect of maternal social background on pregnancy outcomes. The Human Development Index (HDI) assesses the following dimensions of human development: life expectancy, education level and income. The objective of our study was to determine if maternal HDI may be used to identify women at increased odds of poor pregnancy outcomes.MethodsWe conducted a longitudinal population-based study in a tertiary centre in Madrid, Spain. The outcome variables were maternal and perinatal/antenatal mortality, preeclampsia (PE), low birth weight (LBW), gestational diabetes mellitus (GDM), preterm delivery (PTD) before 37 and 34 gestational weeks, abnormal cardiotocography (CTG) during delivery, C-section (CS) due to abnormal CTG, pH < 7.10 at birth, Apgar at 5 min ≤ 7, and resuscitation type ≥3. We performed multivariate logistic regression analyses adjusted for potential confounding variables to evaluate the associations between maternal HDI and perinatal outcomes.ResultsIn total, 38,719 singleton infants who were born in our maternity ward between 2010 and 2016 and had perinatal outcome data available were included in this study. The neonates of women from medium/low HDI countries had significantly lower odds of low birth weight (LBW) than their very high HDI country counterparts (OR 0.63, 95% CI 0.55–0.72). However, the odds of PTD before 37 gestational weeks and PE were higher in the medium/low HDI group than the very high HDI group (OR 1.26, 95% CI 1.04–1.53; OR 1.35, 95% CI 1.02–1.79, respectively). Poorer neonatal outcomes were identified in the medium/low HDI group than the very high HDI group, including greater odds of abnormal CTG, CS due to abnormal CTG and Apgar 2 ≤ 7 (p < 0.05).ConclusionsOur findings suggest that the infants of mothers from medium/low HDI had lower odds of LBW but higher odds of PTD, PE and poor neonatal outcomes. These results support the hypothesis that maternal HDI can be used to understand the impact of maternal origin on pregnancy outcomes. Further studies are needed to confirm its validity.

show abstract

Maternal Origin and Risk of Neonatal and Maternal ICU Admission*

Abstract: Women from Africa and the Caribbean and, in particular, Ghana and Jamaica, are at higher risk of admission to ICU around the time of delivery, as are their newborns.

Cited by 9 publications

References 37 publications

Associations between ethnicity and admission to intensive care among women giving birth: a cohort study

Associations between ethnicity and admission to intensive care among women giving birth: a cohort study

Infertility treatment and risk of severe maternal morbidity: a propensity score–matched cohort study

Human Development Index (HDI) of the maternal country of origin as a predictor of perinatal outcomes - a longitudinal study conducted in Spain

Contact Info

Product

Resources

About