Birth
Volume 42, Issue 2, 2015, Pages 116-124

Maternal health and pregnancy outcomes comparing migrant women born in humanitarian and nonhumanitarian source countries: A retrospective, observational study (Article)

Gibson-Helm M.E. , Teede H.J. , Cheng I.-H. , Block A.A. , Knight M. , East C.E. , Wallace E.M. , Boyle J.A.*
  • a Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
  • b Monash Health, Clayton, VIC, Australia
  • c Southern Academic Primary Care Research Unit, School of Primary Health Care, Monash University, Dandenong, VIC, Australia, South Eastern Melbourne Medicare Local, Dandenong, VIC, Australia
  • d Dandenong Hospital, Monash Health, Dandenong, VIC, Australia
  • e Monash Women's Maternity Services, Monash Health, Clayton, VIC, Australia
  • f School of Nursing and Midwifery, Monash University ClaytonVIC, Australia
  • g Monash University ClaytonVIC, Australia
  • h Monash Centre for Health Research and Implementation, Monash University ClaytonVIC, Australia

Abstract

Background: The relationship between migration and pregnancy outcomes is complex, with little insight into whether women of refugee background have greater risks of adverse pregnancy outcomes than other migrant women. This study aimed to describe maternal health, pregnancy care, and pregnancy outcomes among migrant women from humanitarian and nonhumanitarian source countries. Methods: Retrospective, observational study of singleton births, at a single maternity service in Australia 2002-2011, to migrant women born in humanitarian source countries (HSCs, n = 2,713) and non-HSCs (n = 10,606). Multivariable regression analysis assessed associations between maternal HSC-birth and pregnancy outcomes. Results: Compared with women from non-HSCs, the following were more common in women from HSCs: age < 20 years (0.6 vs 2.9% p < 0.001), multiparity (51 vs 76% p < 0.001), body mass index (BMI) ≥ 25 (38 vs 50% p < 0.001), anemia (3.2 vs 5.9% p < 0.001), tuberculosis (0.1 vs 0.4% p = 0.001), and syphilis (0.4 vs 2.5% p < 0.001). Maternal HSC-birth was independently associated with poor or no pregnancy care attendance (OR 2.5 [95% CI 1.8-3.6]), late first pregnancy care visit (OR 1.3 [95% CI 1.1-1.5]), and postterm birth (> 41 weeks gestation) (OR 2.5 [95% CI 1.9-3.4]). Stillbirth (0.8 vs 1.2% p = 0.04, OR 1.5 [95% CI 1.0-2.4]) and unplanned birth before arrival at the hospital (0.6 vs 1.2% p < 0.001, OR 1.3 [95% CI 0.8-2.1]) were more common in HSC-born women but not independently associated with maternal HSC-birth after adjusting for age, parity, BMI and relative socioeconomic disadvantage. Conclusions: These findings suggest areas where women from HSCs may have additional needs in pregnancy compared with women from non-HSCs. Refugee-focused strategies to support engagement in pregnancy care and address maternal health needs would be expected to improve health outcomes in resettlement countries. © 2015 Wiley Periodicals, Inc.

Author Keywords

maternal health Pregnancy care pregnancy outcomes migrant Refugee

Index Keywords

refugee prenatal care Australia maternal health demography Pregnancy Complications human Refugees statistics and numerical data comparative study ethnology Residence Characteristics Humans classification female Socioeconomic Factors socioeconomics pregnancy pregnancy outcome adult migration maternal welfare Transients and Migrants
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84929519917&doi=10.1111%2fbirt.12159&partnerID=40&md5=6ccfd739269fec842938369a774871d1
DOI: 10.1111/birt.12159
ISSN: 07307659
Cited by: 15
Original Language: English