PLoS ONE
Volume 10, Issue 3, 2015

The role of prenatal care and social risk factors in the relationship between immigrant status and neonatal morbidity: A Retrospective cohort study (Article)

Paz-Zulueta M. , Llorca J. , Sarabia-Lavín R. , Bolumar F. , Rioja L. , Delgado A. , Santibáñez M.
  • a Departamento de Enfermería, Universidad de Cantabria, Santander, Spain
  • b Departamento de Salud Pública, Universidad de Cantabria, Santander, Spain, Institute de Investigatión Marqués de Valdecilla (IDIVAL), Santander, Spain, Centra Investigation Biomedicaen Red (CIBER)de Epidemiologiay Salud Publica (CIBERESP), Madrid, Spain
  • c Departamento de Enfermería, Universidad de Cantabria, Santander, Spain
  • d Centra Investigation Biomedicaen Red (CIBER)de Epidemiologiay Salud Publica (CIBERESP), Madrid, Spain, Epidemiology and Biostatistics Program, City University of New York (CUNY), School of Public Health, New York, United States, Departamento de Salud Pública, Universidad de Alcalá de Henares, Madrid, Spain
  • e Gerencia de Atención Primaria, Servicio Cántabro de Salud, Santander, Spain
  • f Gerencia de Atención Primaria, Servicio Cántabro de Salud, Santander, Spain
  • g Departamento de Salud Pública, Universidad de Cantabria, Santander, Spain, Institute de Investigatión Marqués de Valdecilla (IDIVAL), Santander, Spain

Abstract

Background and Aim: Literature evaluating association between neonatal morbidity and immigrant status presents contradictory results. Poorer compliance with prenatal care and greater social risk factors among immigrants could play roles as major confounding variables, thus explaining contradictions. We examined whether prenatal care and social risk factors are confounding variables in the relationship between immigrant status and neonatal morbidity. Methods: Retrospective cohort study: 231 pregnant African immigrant women were recruited from 2007-2010 in northern Spain. A Spanish population sample was obtained by simple random sampling at 1:3 ratio. Immigrant status (Spanish, Sub-Saharan and Northern African), prenatal care (Kessner Index adequate, intermediate or inadequate), and social risk factors were treated as independent variables. Low birth weight (LBW < 2500 grams) and preterm birth (< 37 weeks) were collected as neonatal morbidity variables. Crude and adjusted odds ratios (OR) were estimated by unconditional logistic regression with 95% confidence intervals (95% CI). Results: Positive associations between immigrant women and higher risk of neonatal morbidity were obtained. Crude OR for preterm births in Northern Africans with respect to nonimmigrants was 2.28 (95% CI: 1.04-5.00), and crude OR for LBW was 1.77 (95% CI: 0.74-4.22). However, after adjusting for prenatal care and social risk factors, associations became protective: adjusted OR for preterm birth = 0.42 (95% CI: 0.14-1.32); LBW = 0.48 (95% CI: 0. 15-1.52). Poor compliance with prenatal care was the main independent risk factor associated with both preterm birth (adjusted OR inadequate care = 17.05; 95% CI: 3.92-74.24) and LBW (adjusted OR inadequate care = 6.25; 95% CI: 1.28-30.46). Social risk was an important independent risk factor associated with LBW (adjusted OR = 5.42; 95% CI: 1.58-18. 62). Conclusions: Prenatal care and social risk factors were major confounding variables in the relationship between immigrant status and neonatal morbidity. © 2015 Paz-Zulueta et al.

Author Keywords

[No Keywords available]

Index Keywords

Cameroon prenatal care human risk assessment immigration language ability Odds Ratio statistics and numerical data morbidity Infant, Premature social worker Young Adult Senegal migrant psychology Humans Adolescent Infant, Newborn Emigrants and Immigrants Spain social problem female risk factor Risk Factors newborn pregnancy Mothers Infant, Low Birth Weight Outcome Assessment (Health Care) Article Retrospective Studies health care utilization low birth weight newborn morbidity Social Environment mother adult prematurity outcome assessment cohort analysis pregnant woman retrospective study health care need Morocco
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84946179882&doi=10.1371%2fjoumal.pone.0120765&partnerID=40&md5=052c14878fecbfef01adc6d3cc4737d7
DOI: 10.1371/joumal.pone.0120765
ISSN: 19326203
Cited by: 5
Original Language: English