Variations in first‐time caesarean birth between Eastern African immigrants and Australian‐born women in public care: A population‐based investigation in Victoria

Belihu, Fetene B.; Small, Rhonda; Davey, Mary‐Ann

doi:10.1111/ajo.12491

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…A total of 77.5% of studies were conducted in Europe [ n = 31, including Norway ( 3 , 34 , 42 , 43 , 49 , 50 , 52 , 54 , 56 ), Finland ( 23 , 24 ), Israel ( 28 , 40 ), Turkey ( 26 – 31 , 33 , 35 , 37 , 39 , 45 , 51 ), Sweden ( 32 , 36 , 38 , 48 ), Finland ( 41 ), Denmark ( 44 , 47 ), Netherlands ( 53 ), UK ( 57 )], 7.5% in Asia [ n = 3, including Lebanon ( 20 ), Jordan ( 21 ), Pakistan ( 22 )], and 12.5% in others ( n = 5, including USA ( 13 , 56 ), Canada ( 46 ), and Australia ( 25 – 27 )].…”

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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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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“…The quality appraisal of the included studies has been presented in supplementary Tables 3 and 4. A total of 106 studies were judged as high quality [ 11 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 …”

Section: Resultsmentioning

confidence: 99%

Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis

Behboudi‐Gandevani

Panahi

Mardani

et al. 2022

Annals of Global Health

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Background: Disparities in health outcomes between immigrant and native-origin populations, particularly pregnant women, pose significant challenges to healthcare systems. The aim of this systematic-review and meta-analysis was to investigate the risk of adverse pregnancy outcomes among immigrant-women compared to native-origin women in the host country.Methods: PubMed (including MEDLINE), Scopus, and Web of Science were searched to retrieve studies published in English language up to September 2020. All observational studies examining the prevalence of at least one of the short-term single pregnancy outcomes for immigrants who crossed international borders compared to native-origin pregnant population were included. The meta-prop method was used for the pooledestimation of adverse pregnancy-outcomes' prevalence. For pool-effect estimates, the association between the immigration-status and outcomes of interest, the randomeffects model was applied using the model described by DerSimonian and Laird. I 2 statistic was used to assess heterogeneity. The publication bias was assessed using the Harbord-test. Meta-regression was performed to explore the effect of geographical region as the heterogeneity source.Findings: This review involved 11 320 674 pregnant women with an immigrationbackground and 56 102 698 pregnant women as the native-origin population. The risk of emergency cesarean section (Pooled-OR = 1.1, 95%CI = 1.0-1.2), shoulder dystocia (Pooled-OR = 1.1, 95%CI = 1.0-1.3), gestational diabetes mellites (Pooled-OR = 1.4, 95%CI = 1.2-1.6), small for gestational age (Pooled-OR=1.3, 95%CI = 1.1-0.4), 5-min Apgar less than 7 (Pooled-OR = 1.2, 95%CI = 1.0-1.3) and oligohydramnios (Pooled-OR = 1.8, 95%CI = 1.0-3.3) in the immigrant women were significantly higher than those with the native origin background. The immigrant women had a lower risk of labor induction (Pooled-OR = *Author affiliations can be found in the back matter of this article 2 Behboudi-Gandevani et al.

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“…Migrants from Sub-Saharan Africa living in high-income countries generally have higher cesarean section rates than non-migrants 24 and Somali women have consistently been found to have higher rates. 21,[25][26][27] Research suggests that poor maternal health, cultural and social circumstances, low quality of care, aspects of the migration, language skills, length of residence, and FGM/C are contributing factors. 24,[28][29][30] Indeed, the overall cesarean section rate among nulliparous women in Norway during the period of study was 16.3% (unpublished data from the Medical Birth Registry of Norway that are available on request from https://helse data.no); more than 40% lower than the rate we found among Somali nulliparous women.…”

Section: Discussionmentioning

confidence: 99%

“…The finding of higher cesarean section risk in women without FGM/C needs to be interpreted in the broader context of cesarean section rates in migrant women. Migrants from Sub‐Saharan Africa living in high‐income countries generally have higher cesarean section rates than non‐migrants 24 and Somali women have consistently been found to have higher rates 21,25‐27 . Research suggests that poor maternal health, cultural and social circumstances, low quality of care, aspects of the migration, language skills, length of residence, and FGM/C are contributing factors 24,28‐30 .…”

Section: Discussionmentioning

confidence: 99%

Female genital mutilation/cutting, timing of deinfibulation, and risk of cesarean section

Taraldsen

Vangen

Øian

et al. 2021

Acta Obstet Gynecol Scand

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Introduction The impact of female genital mutilation/cutting on obstetric outcomes in high‐income countries is not clear. In general, women with female genital mutilation/cutting type 3 (infibulation) seem to be most at risk of adverse outcomes such as cesarean section. Deinfibulation is recommended to prevent obstetric complications. Whether the timing of this procedure affects the complication risk is not known. The aims of this study were, first, to examine the association between female genital mutilation/cutting and the risk of cesarean section in Norway, and, second, whether the timing of deinfibulation affected the cesarean section risk. Material and methods This was a historical cohort study of nulliparous Somali‐born women who gave birth in Norway between 1990 and 2014. The Medical Birth Registry of Norway identified the women. Data were collected from medical records at 11 participating birth units. The exposures were female genital mutilation/cutting status and deinfibulation before pregnancy, during pregnancy, or no deinfibulation before labor onset. The main outcome was odds ratio (OR) of cesarean section. Type of cesarean section, primary indications, and neonatal outcomes were secondary outcomes. Results Women with female genital mutilation/cutting type 3 had lower risk of cesarean section compared with women with no female genital mutilation/cutting (OR 0.54, 95% CI 0.33‐0.89 P = .02). Among the 1504 included women, the cesarean section rate was 28.0% and the proportion of emergency operations was 92.9%. Fetal distress was the primary indication in approximately 50% of cases, across the groups with different female genital mutilation/cutting status. Women who had no deinfibulation before labor onset had lower risk of cesarean section compared with those who underwent deinfibulation before or during pregnancy (OR 0.64, 95% CI 0.46‐0.88 P = .01). Conclusions High risk of cesarean section in Somali nulliparous women was not related to the type of female genital mutilation/cutting in the present study. Deinfibulation before labor did not protect against cesarean section. Our findings indicate that nulliparous Somali women are at high risk of intrapartum complications. Future research should focus on measures to reduce maternal morbidity and on how timing of deinfibulation affects the outcomes of vaginal births.

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Variations in first‐time caesarean birth between Eastern African immigrants and Australian‐born women in public care: A population‐based investigation in Victoria

Cited by 7 publications

References 30 publications

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

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

Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis

Female genital mutilation/cutting, timing of deinfibulation, and risk of cesarean section

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