Pregnancy Outcome of Migrant Women Delivering in a Public Institution in Northern Italy

Abstract

Background/Aim: European societies are facing a wave of incoming immigrants and the needs of a new multiethnic obstetrical population. It remains controversial whether native and immigrant women have equivalent pregnancy outcomes. Methods: Perinatal indicators of the obstetric outcome were monitored in all delivering women during a 5-year period in a large academic public general hospital. We compared rates of preterm deliveries, low birth weight, cesarean section during labor, perineal tears, and fetal acidemia in the native and immigrant parturients. Results: Immigrant women experienced very low birth weight (p < 0.005) and preterm deliveries (p < 0.05), more often than natives did. Among ethnic groups, data singled out Sub-Saharan African women to be at a higher risk for very small premature babies and cesarean section during labor. Conclusions: There are differences in perinatal outcome between immigrant and Italian woman; within the large migrant population, ethnic groups show wide disparities and challenge the health provider differently. Special attention to women at a higher risk may reduce fetal-maternal morbidities.

International migration and caesarean birth: a systematic review and meta-analysis

“…US [37,57,81] and Southern European [25,26,88] studies were too heterogeneous to combine, but tended towards higher rates. Analysis by parity showed primiparous African women to be more likely to have a caesarean [OR=2.24 (95% CI=1.63, 3.08)] [31,33,46,64] than non-migrants see Figure 1; multiparous women were also at increased risk [OR=2.02 (95%CI=1.51, 2.71)] [31,46].…”

“…Analysis by type of caesarean suggests an excess risk of emergency caesareans for Sub-Saharan African women (all estimates above 1), although results were heterogeneous [17,31,33,64,82,88,91,94]. Risks for elective caesareans varied by receiving-country; three studies in France [17,31,94], one in Italy [88] and another in Australia [91] showed higher risks of a planned caesarean, while two other studies, one in Canada [64] and the other in Norway [82], found African women to have the same and lower risk respectively.…”

“…Risks for elective caesareans varied by receiving-country; three studies in France [17,31,94], one in Italy [88] and another in Australia [91] showed higher risks of a planned caesarean, while two other studies, one in Canada [64] and the other in Norway [82], found African women to have the same and lower risk respectively.…”

“…Analysis for other countries/regions yielded heterogeneous results. With respect to type of caesarean, North African/West Asian migrant women had an elevated risk if the caesarean was an emergency [OR=1.11 (95% CI=1.03, 1.20)] [15,17,31,33,64,88,91,94]. …”

Perinatal Mortality and Advanced Maternal Age

“…Therefore, our study describes the impact of maternal age on perinatal mortality in a typical central European region with different ethnic groups and varying socioeconomic standards. Zanconato et al [16] previously demonstrated the impact of socioeconomic factors and ethnicity on the pregnancy outcome.…”