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.
  • a Department of Gynecology, Campus Virchow-Klinikum, Klinik für Gynäkologie, Charité University Hospital, Augustenburger Platz 1, Berlin, 13353, Germany
  • b Department of Epidemiology and International Public Health; Bielefeld School of Public Health, Bielefeld University, Bielefeld, Germany
  • c Department of Obstetrics, Virchow and Mitte Campuses, Charité University Hospital, Berlin, Germany
  • d Department of Obstetrics, Vivantes Hospital Neukölln, Berlin, Germany
  • e Department of Obstetrics, Vivantes Hospital Neukölln, Berlin, Germany
  • 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.

Author Keywords

perinatal data Migration Maternal near miss Acculturation

Index Keywords

prospective study immigrant clinical outcome Germany human perinatal period controlled study premature labor language lung embolism pH cardiovascular disease female maternal death postpartum hemorrhage cultural factor Article health care utilization major clinical study adult migration uterus rupture hysterectomy HELLP syndrome eclampsia maternal near miss multipara high risk pregnancy disease severity quantitative analysis sepsis health care disparity

Link
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