Risk of adverse outcomes among infants of immigrant women according to birth-weight curves tailored to maternal world region of origin

CMAJ
Volume 187, Issue 1, 2015, Pages E32-E40

Risk of adverse outcomes among infants of immigrant women according to birth-weight curves tailored to maternal world region of origin (Article) (Open Access)

Urquia M.L.* , Berger H. , Ray J.G. , Babaran-Henfrey K. , Bismilla S. , Bocking A. , Booth M. , Campbell D. , Chiu M. , Colizza L. , de Groh M. , De Souza L. , Glazier R. , Guttmann A. , Handa M. , Hilliard R. , Longo C. , Maguire J. , Mousmanis P. , Park A. , Roukema H. , Roy J. , Sgro M. , Smith G.N. , Tu K. , Vanderkooy P. , Urquia M. , Watson W. , Watts N.

^a Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Canada, Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, ON, Canada
^b Department of Medicine, St. Michael's Hospital, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada, Faculty of Medicine, University of Toronto, Toronto, ON, Canada;
^c Department of Medicine, St. Michael's Hospital, Canada, Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, ON, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada, Faculty of Medicine, University of Toronto, Toronto, ON, Canada;
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Abstract

Background: Infants of immigrant women in Western nations generally have lower birth weights than infants of native-born women. Whether this difference is physiologic or pathological is unclear. We determined whether the use of birth-weight curves tailored to maternal world region of origin would discriminate adverse neonatal and obstetric outcomes more accurately than a single birth-weight curve based on infants of Canadian-born women. Methods: We performed a retrospective cohort study of in-hospital singleton live births (328 387 to immigrant women, 761 260 to nonimmigrant women) in Ontario between 2002 and 2012 using population health services data linked to the national immigration database. We classified infants as small for gestational age (< 10th percentile) or large for gestational age (≥ 90th percentile) using both Canadian and world region-specific birthweight curves and compared associations with adverse neonatal and obstetric outcomes. Results: Compared with world region-specific birth-weight curves, the Canadian curve classified 20 431 (6.2%) additional newborns of immigrant women as small for gestational age, of whom 15 467 (75.7%) were of East or South Asian descent. The odds of neonatal death were lower among small-for-gestational-age infants of immigrant women than among those of nonimmigrant women based on the Canadian birth-weight curve (adjusted odds ratio [OR] 0.83, 95% confidence interval [CI] 0.72-0.95), but higher when small for gestational age was defined by the world region- specific curves (adjusted OR 1.24, 95% CI 1.08- 1.42). Conversely, the odds of some adverse outcomes were lower among large-forgestational- age infants of immigrant women than among those of nonimmigrant women based on world region-specific birth-weight curves, but were similar based on the Canadian curve. Interpretation: World region-specific birthweight curves seemed to be more appropriate than a single Canadian population-based curve for assessing the risk of adverse neonatal and obstetric outcomes among small- and large-for-gestational-age infants born to immigrant women, especially those from the East and South Asian regions. © 2015 8872147 Canada Inc.

Author Keywords

[No Keywords available]

Index Keywords

immigrant Registries South Asian fetus hypoxia shoulder dystocia Follow-Up Studies register follow up human epidemiology perinatal asphyxia middle aged statistics and numerical data East Asian birth injury ethnology reference value Young Adult Humans migrant Adolescent Asia, Southeastern Infant, Newborn male artificial ventilation female large for gestational age Southeast Asia Emigrants and Immigrants newborn adverse outcome Africa Canadian Caribbean Article Retrospective Studies Ontario pregnancy outcome adult small for date infant prematurity fetus outcome cohort analysis retrospective study gestational age Birth Weight Reference Values newborn death

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84920554671&doi=10.1503%2fcmaj.140748&partnerID=40&md5=97226382ee1791e5f5e0e084e6989f8f

DOI: 10.1503/cmaj.140748

ISSN: 08203946

Cited by: 25

Original Language: English