Trends in sociodemographic and health care factors in Portuguese and non‐Portuguese mothers giving birth in Portugal, 1995‐2014

Abstract

Background Time‐trend disparity in adverse pregnancy outcomes according to maternal nationality or immigration status has been well documented. In this study, we investigated time changes in individual‐level risk factors for adverse pregnancy outcomes that have not been given the needed attention. Objective To compare 20‐year trends in sociodemographic, obstetric, health care factors, and adverse pregnancy outcomes in Portuguese and non‐Portuguese women. Methods We studied 2 105 497 livebirths from Portuguese national birth registry (1995‐2014). We compared maternal sociodemographic characteristics (age, education, employment, and marital status), obstetric, and health care factors (parity, number of foetuses, place and type of delivery) in Portuguese and non‐Portuguese at four periods (1995‐1999, 2000‐2004, 2005‐09, and 2010‐2014). Time‐trend analysis using joinpoint regression method was performed to identify trends (joinpoints) and compare time changes in the prevalence of sociodemographic, obstetric, and health care factors expressed as annual percentage change (APC). Results The proportion of livebirths in non‐Portuguese mothers increased between 1995 and 1999 (2.9%), 2000‐2004 (6.3%), 2005‐2009 (9.5%), and 2010‐2014 (9.8%). The proportion of women aged ≥ 35 years among Portuguese mothers varied from 11.1% (1995‐1999), 14.4% (2000‐2004), 18.6% (2005‐2009) to 25.5% (2010‐2014); among non‐Portuguese women, the corresponding proportions were 15.7% (1995‐1999), 14.6% (2000‐2004), 16.1% (2005‐2009), and 19.0% (2010‐2014), respectively. The rate of change in maternal age ≥ 35 years had 2 joinpoints in both Portuguese (APC = 6.5%, 95% confidence interval [CI] 6.2, 6.9; 2005‐2014) and non‐Portuguese (3.3%, 95% CI 2.5, 4.0; 2002‐2014). Increase in caesarean rate was higher for non‐Portuguese (24.0%‐36.1%) than the Portuguese (30.6%‐31.6%) between 1995 and 2014. Conclusions Sociodemographic, obstetric, and health care factors have divergent time trends and rate of change for Portuguese and non‐Portuguese.

Cesarean birth rates among migrants in Europe: A systematic review

“…One additional paper was identified for full‐text assessment through searching reference lists of included studies, resulting in full‐text assessment being carried out on 54 papers in total. Twenty‐one papers were included in the final review and analysis 28–48 . Figure 1 illustrates the selection process, the number of studies identified and excluded at each stage, and the reasons for exclusion, in line with the PRISMA 2020 statement 49 .…”

Secular trends of socio-demographic and lifestyle characteristics among delivering women in Arctic Russia, 1973-2017

“…Pregnancy complications and adverse birth outcomes linked to social inequalities and unhealthy behaviours are important public health concerns. Maternal age [ 1–3 ], occupation [ 2 ], marital status [ 2 ], education [ 3 ], and lifestyle characteristic [ 4–6 ] are considered to be the most important social determinants of pregnancy outcomes. Advanced age has been shown to be associated with increased risk of pregnancy complications [ 7 ], risk of caesarean section [ 8 , 9 ], stillbirth and adverse neonatal outcomes [ 10 ].…”