Background: Adult immigrants in Canada have a survival advantage over their Canadian-born counterparts. It is unknown whether migrants are able to transmit their survival advantage to their Canadian-born children. Methods: Neonatal and postneonatal mortality between the Canadian-born population and 12 immigrant subgroups were compared using 1990-2005 linked birth-infant death records. Age-at-death specific mortality rates and rate differences were calculated by nativity status and maternal birthplace. A chi-square statistic was used to compare group differences in maternal sociodemographic characteristics. Multivariate survival analysis was used to estimate the effect of maternal birthplace on neonatal and postneonatal mortality, net of maternal sociodemographic and infant characteristics. Results: Overall, immigrants had lower rates of neonatal and postneonatal mortality than the Canadian-born population. But the adjusted risk of neonatal mortality was higher for Sub-Saharan African (hazard ratio [HR] = 1.32; 95 % confidence interval [CI] = 1.05, 1.66), Haitian (HR = 2.29, 95 % CI = 1.90, 2.76), non-Spanish Caribbean (HR = 1.38; 95 % CI = 1.01, 1.89), and Pakistani (HR = 1.87; 95 % CI = 1.31, 2.68) migrants relative to Canadian-born women. There were fewer significant disparities in postneonatal death, with higher adjusted risks of mortality observed for Pakistani (HR = 2.67, 95 % CI = 1.77, 4.02) and Haitian (HR = 1.41, 95 % CI = 1.02, 1.97) migrants only. Conclusion: Inequalities in infant mortality are more concentrated in the neonatal period. Contingent on surviving the first 27 days after birth, the infants of most immigrants (except those from Haiti and Pakistan) have the same chances of survival as the infants of Canadian-born women. Improvements in prenatal care and access to postpartum care may reduce disparities in infant mortality. © 2016 The Author(s).

Healthy immigrant effect Infant mortality Maternal child health Population-based data Canada

Pakistan Pakistani educational status data assimilation immigrant non immigrant Africa south of the Sahara prenatal care maternal health Maternal Age survival rate survival health disparity Health Status Disparities risk human ancestry group epidemiology birthplace Ethnic Groups ethnic group priority journal comparative study African infant death ethnology perinatal death Haitian Haiti Young Adult Humans migrant Infant, Newborn Canada male Emigrants and Immigrants female Infant risk factor geographic origin newborn demographic survey pregnancy Mothers age structure child health Canadian Article mother adult migration age Infant Mortality newborn mortality Emigration and Immigration non Spanish Caribbean puerperium child death citizen group immigrant population