The Effect of Immigration on Adverse Perinatal Outcomes: Analysis of Experiences at a Turkish Tertiary Hospital

Madendağ, İlknur Çöl; Şahin, Mefküre Eraslan; Madendağ, Yusuf; Şahin, Erdem; Demir, Mustafa; Özdemir, Fatma Nurhan; Açmaz, Gökhan; Müderris, İptisam İpek

doi:10.1155/2019/2326797

Cited by 15 publications

(14 citation statements)

References 15 publications

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“…In the present study, we aimed to evaluate the effect of immigration on adverse maternal and perinatal outcomes recorded ten years before. The prevalence was in line with that seen in other European countries, such as Turkish (32%) 22 and Germany (32.9%). 23 We analyzed the obstetric outcomes of 1092 immigrants compared to 2464 native patients, with a glimpse into potential differences in pregnancy complications.…”

Section: Discussionsupporting

confidence: 88%

“…Recently, several Italian hospitals have focused their research on the obstetric outcomes of immigrated women compared to the native population; however, results were quite heterogeneous. [22][23][24][25] The aim of the study was to compare pregnancy and perinatal outcomes between long-term (≥ 2 years of residence) immigrant women and the native population in an Italian free care hospital.…”

Section: Introductionmentioning

confidence: 99%

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Immigration and Adverse Pregnancy Outcomes in an Italian Free Care Hospital

Caruso¹,

Marcoccia²,

Brunelli³

et al. 2021

IJWH

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Introduction:The ever-increasing wave of immigration in Italy has posed demanding challenges in the management of the new multiethnic obstetric population. The aim of this study was to compare pregnancy and perinatal outcomes between immigrants and the native population in an Italian public hospital. Materials and Methods: Singleton pregnant women (≥ 24 weeks of gestation) who delivered during a 3-year period in an Italian free care hospital were included. Long-term (≥ 2 years of residence) immigrant patients were divided into 4 groups according to their ethnic origin: Europeans, Asians, Latin Americans, and Africans. Perinatal indicators of obstetric outcomes were collected and compared between immigrants and Italians. Results: Of the 3556 patients included, 1092 were immigrants and 2464 Italians. The immigrant cohort experienced a higher rate of macrosomia (1.8% vs 0.6%; p = 0.001), very low birth weight (1.3% vs 0.6%; p = 0.048), very early preterm delivery (1.4% vs 0.4%; p = 0.048), and gestational diabetes mellitus (1.8% vs 0.5%; p = 003) compared with the native population. The overall rate of cesarean sections was greater among Italians (56% vs 45.8%; p < 0.001). Among ethnic groups, Europeans and Latin Americans reported a higher rate of preterm delivery (20.2% and 19%, respectively; p < 0.001). Latin Americans carried also a greater risk of fetal macrosomia (3.6%; p < 0.008), while the rate of very low birth weight was higher among Europeans and Africans (2% and 1.8%, respectively; p < 0.04). Conclusion:Obstetricians should pay special attention to the potential disparities in pregnancy outcomes between immigrants and the native population. Future efforts should focus on reducing preterm delivery and glucose dysmetabolism among pregnant immigrants.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Immigration and Adverse Pregnancy Outcomes in an Italian Free Care Hospital

Caruso¹,

Marcoccia²,

Brunelli³

et al. 2021

IJWH

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“…The quality appraisal of the included studies has been presented in Supplementary Tables 2, 3 . A total of 30 studies were judged as high quality ( 3 , 13 , 20 , 22 – 26 , 28 , 30 , 32 , 34 , 36 – 38 , 40 – 44 , 46 – 50 , 52 , 54 – 56 ); 10 for moderate quality ( 21 , 29 , 31 , 33 , 35 , 39 , 45 , 51 , 53 , 57 ); and no study had low quality.…”

Section: Resultsmentioning

confidence: 99%

Perinatal and Neonatal Outcomes in Immigrants From Conflict-Zone Countries: A Systematic Review and Meta-Analysis of Observational Studies

Behboudi‐Gandevani

Panahi

Mardani

et al. 2022

Front. Public Health

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ObjectivesThere are controversies regarding the risk of adverse pregnancy outcomes among immigrants from conflict-zone countries. This systematic review and meta-analysis aimed to investigate the risk of perinatal and neonatal outcomes among immigrants from conflict-zone countries compared to native-origin women in host countries.MethodsA systematic search on the databases of PubMed/MEDLINE, Scopus, and Web of Science was carried out to retrieve studies on perinatal and neonatal outcomes among immigrants from Somalia, Iraq, Afghanistan, Yemen, Syria, Nigeria, Sudan, Ethiopia, Eritrea, Kosovo, Ukraine, and Pakistan. Only peer-reviewed articles published in the English language were included in the data analysis and research synthesis. The odds ratio and forest plots were constructed for assessing the outcomes of interests using the DerSimonian and Laird, and the inverse variance methods. The random-effects model and the Harbord test were used to account for heterogeneity between studies and assess publication bias, respectively. Further sensitivity analysis helped with the verification of the reliability and stability of our review results.ResultsThe search process led to the identification of 40 eligible studies involving 215,718 pregnant women, with an immigration background from the conflict zone, and 12,806,469 women of native origin. The adverse neonatal outcomes of the risk of small for gestational age (Pooled OR = 1.8, 95% CI = 1.6, 2.1), a 5-min Apgar score <7 (Pooled OR = 1.4, 95% CI = 1.0, 2.1), stillbirth (Pooled OR = 1.9, 95% CI = 1.2, 3.0), and perinatal mortality (Pooled OR = 2, 95% CI = 1.6, 2.5) were significantly higher in the immigrant women compared to the women of native-origin. The risk of maternal outcomes, including the cesarean section (C-S) and emergency C-S, instrumental delivery, preeclampsia, and gestational diabetes was similar in both groups.ConclusionAlthough the risk of some adverse maternal outcomes was comparable in the groups, the immigrant women from conflict-zone countries had a higher risk of neonatal mortality and morbidity, including SGA, a 5-min Apgar score <7, stillbirth, and perinatal mortality compared to the native-origin population. Our review results show the need for the optimization of health care and further investigation of long-term adverse pregnancy outcomes among immigrant women.

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“…The main characteristics of the selected studies have been outlined in Table 1 . The studies were conducted in Europe ( n = 37; Spain [ 23 , 33 ], Finland [ 25 , 34 ], Israel [ 9 , 15 ], Turkey [ 22 , 24 , 35 – 38 ], Sweden [ 12 , 13 , 39 , 40 ], Norway [ 16 , 19 , 41 – 45 ], Belgium [ 17 , 18 , 45 , 46 ], United Kingdom [ 45 , 47 ], Netherlands [ 20 , 45 ], Denmark [ 45 , 48 ], Switzerland [ 45 ], Austria [ 45 ], Germany [ 45 ] and Italy [ 49 ]), America ( n = 8; Canada [ 21 , 26 , 50 ], USA [ 51 – 53 ] and Argentina [ 4 , 54 ]), Australia ( n = 5) [ 8 , 10 , 11 , 14 , 55 ]), and Taiwan ( n = 1) [ 56 , 57 ]. The results of quality appraisals of the included studies have been summarized in Supplementary Tables S1, S2 .…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of the Risk of Stillbirth, Perinatal and Neonatal Mortality in Immigrant Women

Behboudi‐Gandevani¹,

Panahi²,

Mardani³

et al. 2022

Int J Public Health

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Objectives: This study aimed to investigate the risk of stillbirth, perinatal and neonatal mortality in immigrant women compared to native-origin women in host countries.Methods: A systematic literature review and meta-analysis was conducted. Relevant studies were identified using a thorough literature search and their quality was appraised. The analysis of heterogeneous data was carried out using the random effects model and publication bias was assessed using the Harbord-test. Also, the pooled odds ratio of events was calculated through the DerSimonian and Laird, and inverse variance methods.Results: In the search process 45 studies were retrieved consisting of 8,419,435 immigrant women and 40,113,869 native-origin women. The risk of stillbirth (Pooled OR = 1.35, 95% CI = 1.22–1.50), perinatal mortality (Pooled OR = 1.50, 95% CI = 1.35–1.68), and neonatal mortality (Pooled OR = 1.09, 95% CI = 1.00–1.19) in the immigrant women were significantly higher than the native-origin women in host countries. According to the sensitivity analyses, all results were highly consistent with the main data analysis results.Conclusion: The immigrant women compared to the native-origin women had the higher risks of stillbirth, perinatal and neonatal mortality. Healthcare providers and policy makers should improve the provision of maternal and neonatal healthcare for the immigrant population.

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The Effect of Immigration on Adverse Perinatal Outcomes: Analysis of Experiences at a Turkish Tertiary Hospital

Cited by 15 publications

References 15 publications

Immigration and Adverse Pregnancy Outcomes in an Italian Free Care Hospital

Immigration and Adverse Pregnancy Outcomes in an Italian Free Care Hospital

Perinatal and Neonatal Outcomes in Immigrants From Conflict-Zone Countries: A Systematic Review and Meta-Analysis of Observational Studies

A Systematic Review and Meta-Analysis of the Risk of Stillbirth, Perinatal and Neonatal Mortality in Immigrant Women

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