Archives of Gynecology and Obstetrics
Volume 300, Issue 2, 2019, Pages 285-292
The impact of migration background on maternal near miss (Article)
David M.* ,
Razum O. ,
Henrich W. ,
Ramsauer B. ,
Schlembach D. ,
Breckenkamp J.
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a
Department of Gynecology, Campus Virchow-Klinikum, Klinik für Gynäkologie, Charité University Hospital, Augustenburger Platz 1, Berlin, 13353, Germany
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b
Department of Epidemiology and International Public Health; Bielefeld School of Public Health, Bielefeld University, Bielefeld, Germany
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c
Department of Obstetrics, Virchow and Mitte Campuses, Charité University Hospital, Berlin, Germany
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d
Department of Obstetrics, Vivantes Hospital Neukölln, Berlin, Germany
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e
Department of Obstetrics, Vivantes Hospital Neukölln, Berlin, Germany
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f
Department of Epidemiology and International Public Health; Bielefeld School of Public Health, Bielefeld University, Bielefeld, Germany
Abstract
Purpose: (1) To evaluate the association between immigration background and the occurrence of maternal near miss (MNM). (2) To identify medical co-factors, health-care utilization, and health-care disparities as explanations of a possibly higher risk of MNM among immigrants. Methods: We compared perinatal outcomes between immigrant women (first- or second-generation) versus non-immigrant women, delivering at three maternity hospitals in Berlin, Germany, 2011–2012. Near-miss events were defined as: HELLP syndrome, eclampsia, the occurrence or threat of uterine rupture, postpartum hemorrhage (PPH) > 1000 ml, sepsis, peripartal hysterectomy, cardiovascular complications, lung embolism. Logistic regression analyses were performed to determine the associations of immigration status, acculturation, and language competency with near-miss events, and of near-miss events with the perinatal outcomes. Results: The databank included 2647 first-generation immigrants, 889 second-generation immigrants, and 3231 women without an immigration background (total N = 6767). Near-miss events occurred in 141 women. The likelihood of near-miss events was lower among multiparous women (OR 0.6; 95% CI 0.42–0.87; p = 0.01). No other factors had a statistically significant influence. Near-miss events are associated with an elevated likelihood for an unfavorable perinatal condition: the ORs ranged from 2.15 for an arterial umbilical cord pH value < 7.1–2.47 for premature delivery. Conclusions: Immigration status does not change the risk of near-miss events. Besides parity, no medical or socio-demographic factors were identified that were associated with an elevated likelihood for the occurrence of severe peripartal complications. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
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https://www.scopus.com/inward/record.uri?eid=2-s2.0-85065747428&doi=10.1007%2fs00404-019-05179-9&partnerID=40&md5=9365024ed92625c8f0a1dcf4001e741a
DOI: 10.1007/s00404-019-05179-9
ISSN: 09320067
Original Language: English