Maternal and Child Health Journal
Volume 15, Issue 2, 2011, Pages 269-279

Neonatal outcomes for immigrant vs. native-born mothers in Taiwan: An epidemiological paradox (Article)

Xirasagar S.* , Fu J.-C. , Liu J. , Probst J.C. , Lin D.-P.
  • a Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Columbia, SC 29208, United States
  • b Department of Obstetrics and Gynecology, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan
  • c Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
  • d Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Columbia, SC 29208, United States
  • e Department of Obstetrics and Gynecology, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan

Abstract

In Taiwan, immigrant women by marriage face social discrimination due to widespread impressions that they give birth to low birth weight, high-risk, high cost babies due to their lower socioeconomic status, shorter stature, and lower pre-pregnant weight than native-born Taiwanese women. This study compared crude and adjusted birth outcomes of immigrant mothers (Chinese and Vietnamese) relative to native-born Taiwanese, and tested for the phenomenon of an epidemiological paradox of favorable neonatal outcomes among immigrants. Data from patient charts of all singleton live births during 2002-2007, weighing ≥500 and <4,000 g, and ≥20 weeks gestational age at a regional hospital in Kaohsiung, Taiwan, were used. Multiple regression analysis was used to test the hypothesis controlling for maternal characteristics (demographics, national origin, obstetric and prenatal factors) and neonatal characteristics (birth weight, gestational age). Of 3,267 births satisfying the inclusion criteria, 19.0% were to Chinese and Vietnamese mothers. Crude birth weight was lowest for Taiwanese mothers, who also had the highest rate of preterm delivery (<37 weeks). The adjusted birth weight for Chinese and Vietnamese mothers was 87.7 and 74.7 g higher, respectively than native-born Taiwanese (both P < 0.001). Chinese and Vietnamese mothers also had lower odds of preterm birth (ORs 0.46 and 0.47, respectively). Findings support paradoxically better neonatal outcomes among Chinese and Vietnamese immigrant mothers in Taiwan. Findings can be used to initiate public education to reverse the widespread negative perceptions and attitudes towards immigrant spouses in Taiwan. © 2010 Springer Science+Business Media, LLC.

Author Keywords

Immigrant birth outcomes Epidemiological paradox Birth weight Preterm delivery

Index Keywords

Vietnam China Asian Population Surveillance human statistics Asian continental ancestry group comparative study Infant, Premature ethnology Taiwan Young Adult Humans Infant, Newborn Emigrants and Immigrants female Viet Nam Infant Socioeconomic Factors newborn socioeconomics pregnancy Mothers Article Retrospective Studies pregnancy outcome mother adult migration prematurity Perinatal Care retrospective study Birth Weight gestational age health survey

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-79551471989&doi=10.1007%2fs10995-010-0612-9&partnerID=40&md5=cc6f8c9973c54cac16521c6b722a89ef

DOI: 10.1007/s10995-010-0612-9
ISSN: 10927875
Cited by: 6
Original Language: English