The influence of refugee status and secondary migration on preterm birth

Wanigaratne, Susitha; Cole, Donald C.; Bassil, Kate; Hyman, Ilene; Moineddin, Rahim; Urquia, Marcelo L.

doi:10.1136/jech-2015-206529

Cited by 47 publications

(37 citation statements)

References 28 publications

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“…Although no previous studies have examined GDM among refugee women, previous research has examined obstetrical outcomes in general. Refugee women were at greater risk of having pregnancy complications such as preterm birth, caesarean section and low birthweight children [21,22]. By contrast, other studies have no increased risk for pregnancy complications for refugee women [23,24], and some even found, similar to our findings among women with GDM, a lower risk of preterm birth [25,26].…”

Section: Discussionsupporting

confidence: 88%

Gestational diabetes care and outcomes for refugee women: a population‐based cohort study

2017

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Section: Discussionsupporting

confidence: 88%

Gestational diabetes care and outcomes for refugee women: a population‐based cohort study

2017

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“… 32 Other research suggests maternal chronic stress is an important risk factor for PTB, 33 particularly among socially disadvantaged populations. 34 Previously published research of ours found that the effect of refugee status on PTB was stronger among refugee mothers who resided in a transition country prior to arriving in Canada 7 with potentially greater exposure to psychosocial stress. The hypothesised physiological mechanism connecting psychosocial stress to both gestational diabetes and PTB involves dysfunction of regulatory hormones in the body—insulin resistance or impaired insulin metabolism leading to gestational diabetes 32 and early release of hormones required for the initiation of labour leading to PTB.…”

Section: Discussionmentioning

confidence: 79%

Refugee maternal and perinatal health in Ontario, Canada: a retrospective population-based study

et al. 2018

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ObjectivesImmigrants are thought to be healthier than their native-born counterparts, but less is known about the health of refugees or forced migrants. Previous studies often equate refugee status with immigration status or country of birth (COB) and none have compared refugee to non-refugee immigrants from the same COB. Herein, we examined whether: (1) a refugee mother experiences greater odds of adverse maternal and perinatal health outcomes compared with a similar non-refugee mother from the same COB and (2) refugee and non-refugee immigrants differ from Canadian-born mothers for maternal and perinatal outcomes.DesignThis is a retrospective population-based database study. We implemented two cohort designs: (1) 1:1 matching of refugees to non-refugee immigrants on COB, year and age at arrival (±5 years) and (2) an unmatched design using all data.Setting and participantsRefugee immigrant mothers (n=34 233), non-refugee immigrant mothers (n=243 439) and Canadian-born mothers (n=615 394) eligible for universal healthcare insurance who had a hospital birth in Ontario, Canada, between 2002 and 2014.Primary outcomesNumerous adverse maternal and perinatal health outcomes.ResultsRefugees differed from non-refugee immigrants most notably for HIV, with respective rates of 0.39% and 0.20% and an adjusted OR (AOR) of 1.82 (95% CI 1.19 to 2.79). Other elevated outcomes included caesarean section (AOR 1.04, 95% CI 1.00 to 1.08) and moderate preterm birth (AOR 1.08, 95% CI 0.99 to 1.17). For the majority of outcomes, refugee and non-refugee immigrants experienced similar AORs when compared with Canadian-born mothers.ConclusionsRefugee status was associated with a few adverse maternal and perinatal health outcomes, but the associations were not strong except for HIV. The definition of refugee status used herein may not sensitively identify refugees at highest risk. Future research would benefit from further refining refugee status based on migration experiences.

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“…5 Department of Pediatrics, Haukeland University Hospital, Bergen, Norway. 6 Centre for Clinical Research Dalarna, Uppsala University, Uppsala, Sweden.…”

Section: Acknowledgementsmentioning

confidence: 99%

“…Migrant women may be of good health, sometimes even better health than the host population; a phenomenon often referred to as the healthy migrant effect [4,5]. However, increased risk of adverse pregnancy outcomes including preterm birth [6,7] and perinatal mortality [8] have been reported for refugees in particular.…”

Section: Introductionmentioning

confidence: 99%

Country of first birth and neonatal outcomes in migrant and Norwegian-born parous women in Norway: a population-based study

Vik

Nilsen

Aasheim

et al. 2020

BMC Health Serv Res

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Background: This study compares subsequent birth outcomes in migrant women who had already had a child before arriving in Norway with those in migrant women whose first birth occurred in Norway. The aim of this study was to investigate the associations between country of first birth and adverse neonatal outcomes (very preterm birth, moderately preterm birth, post-term birth, small for gestational age, large for gestational age, low Apgar score, stillbirth and neonatal death) in parous migrant and Norwegian-born women. Methods: National population-based study including second and subsequent singleton births in Norway from 1990 to 2016. Data were retrieved from the Medical Birth Registry of Norway and Statistics Norway. Neonatal outcomes were compared between births to: 1) migrant women with a first birth before immigration to Norway (n = 30,062) versus those with a first birth after immigration (n = 66,006), and 2) Norwegian-born women with a first birth outside Norway (n = 6205) versus those with a first birth in Norway (n = 514,799). Associations were estimated as crude and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) using multiple logistic regression. Results: Migrant women with a first birth before immigrating to Norway had increased odds of adverse outcomes in subsequent births relative to those with a first birth after immigration: very preterm birth (22-31 gestational weeks;

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The influence of refugee status and secondary migration on preterm birth

Abstract: Refugee status, jointly with secondary migration, influences PTB among migrants.

Cited by 47 publications

References 28 publications

Gestational diabetes care and outcomes for refugee women: a population‐based cohort study

Gestational diabetes care and outcomes for refugee women: a population‐based cohort study

Refugee maternal and perinatal health in Ontario, Canada: a retrospective population-based study

Country of first birth and neonatal outcomes in migrant and Norwegian-born parous women in Norway: a population-based study

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