BJOG: An International Journal of Obstetrics and Gynaecology
Volume 121, Issue 12, 2014, Pages 1492-1500

Disparities in pre-eclampsia and eclampsia among immigrant women giving birth in six industrialised countries (Article)

Urquia M.L.* , Glazier R.H. , Gagnon A.J. , Mortensen L.H. , Nybo Andersen A.-M. , Janevic T. , Guendelman S. , Thornton D. , Bolumar F. , Río Sánchez I. , Small R. , Davey M.-A. , Hjern A.
  • a St. Michael's Hospital, Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, 30 Bond Street, Toronto, ON M5B 1W8, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
  • b St. Michael's Hospital, Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, 30 Bond Street, Toronto, ON M5B 1W8, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
  • c Ingram School of Nursing, Department of Obstetrics and Gynecology and Research, Institute of the McGill University Health Centre McGill University, Montreal, QC, Canada
  • d Department of Public Health, Section of Social Medicine University of Copenhagen, Copenhagen, Denmark
  • e Department of Public Health, Section of Social Medicine University of Copenhagen, Copenhagen, Denmark
  • f Rutgers School of Public Health, Piscataway, NJ, United States
  • g School of Public Health, University of California, Berkeley, CA, United States
  • h School of Public Health, University of California, Berkeley, CA, United States
  • i CIBERESP and Universidad de Alcalá, Madrid, Spain
  • j National Centre of Epidemiology, Madrid, Spain
  • k Judith Lumley Centre, School of Nursing and Midwifery, Faculty of Health Sciences, La Trobe University, Melbourne, VIC, Australia
  • l Judith Lumley Centre, School of Nursing and Midwifery, Faculty of Health Sciences, La Trobe University, Melbourne, VIC, Australia
  • m Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Centre for Health Equity Studies, Stockholm, Sweden

Abstract

Objective To assess disparities in pre-eclampsia and eclampsia among immigrant women from various world regions giving birth in six industrialised countries. Design Cross-country comparative study of linked population-based databases. Setting Provincial or regional obstetric delivery data from Australia, Canada, Spain and the USA and national data from Denmark and Sweden. Population All immigrant and non-immigrant women delivering in the six industrialised countries within the most recent 10-year period available to each participating centre (1995-2010). Methods Data was collected using standardised definitions of the outcomes and maternal regions of birth. Pooled data were analysed with multilevel models. Within-country analyses used stratified logistic regression to obtain odds ratios (OR) with 95% confidence intervals (95% CI). Main outcome measures Pre-eclampsia, eclampsia and pre-eclampsia with prolonged hospitalisation (cases per 1000 deliveries). Results There were 9 028 802 deliveries (3 031 399 to immigrant women). Compared with immigrants from Western Europe, immigrants from Sub-Saharan Africa and Latin America & the Caribbean were at higher risk of pre-eclampsia (OR: 1.72; 95% CI: 1.63, 1.80 and 1.63; 95% CI: 1.57, 1.69) and eclampsia (OR: 2.12; 95% CI: 1.61, 2.79 and 1.55; 95% CI: 1.26, 1. 91), respectively, after adjustment for parity, maternal age and destination country. Compared with native-born women, European and East Asian immigrants were at lower risk in most industrialised countries. Spain exhibited the largest disparities and Australia the smallest. Conclusion Immigrant women from Sub-Saharan Africa and Latin America & the Caribbean require increased surveillance due to a consistently high risk of pre-eclampsia and eclampsia. © 2014 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

Author Keywords

Eclampsia Pregnancy complications health disparities Industrialised countries pre-eclampsia Immigration

Index Keywords

immigrant South and Central America Africa south of the Sahara Latin America Australia Maternal Age Europe European health disparity Health Status Disparities human epidemiology industrialization middle aged Denmark statistics and numerical data controlled study Developed Countries East Asian priority journal Far East sensitivity analysis Logistic Models Western Europe comparative study length of stay Databases, Factual factual database ethnology United States Young Adult Sweden Humans migrant Canada Emigrants and Immigrants female Spain pregnancy high risk population Caribbean Region Caribbean Incidence Article major clinical study adult preeclampsia eclampsia developed country parity statistical model childbirth Pre-Eclampsia
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84914674069&doi=10.1111%2f1471-0528.12758&partnerID=40&md5=d36cb4c26685e880576ec3ef4c0b9158
DOI: 10.1111/1471-0528.12758
ISSN: 14700328
Cited by: 23
Original Language: English