Archives of Gynecology and Obstetrics
Volume 296, Issue 4, 2017, Pages 745-762

Obstetric and perinatal outcomes among immigrant and non-immigrant women in Berlin, Germany (Article)

David M.* , Borde T. , Brenne S. , Ramsauer B. , Henrich W. , Breckenkamp J. , Razum O.
  • a Department of Gynecology, Charité University Medicine Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany
  • b Alice Salomon University of Applied Sciences, Berlin, Germany
  • c Department of Gynecology, Charité University Medicine Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany
  • d Department of Obstetrics, Vivantes Klinikum Neukölln, Berlin, Germany
  • e Department of Obstetrics, Charité University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany, Department of Obstetrics, Charité University Medicine Berlin, Campus Charité Mitte, Berlin, Germany
  • f Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
  • g Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany

Abstract

Background: In Germany, regular immigrants and their descendants have legal and financial access to health care equal to the general citizenry. Nonetheless, some of their health outcomes are comparatively unfavorable, and that is only partially explained by their lower socioeconomic status (SES). The aim of this study was to assess whether this disparity exists also for obstetric and perinatal outcomes. Methods: We compared obstetric and perinatal outcomes between immigrant women (first or second generation) and non-immigrant women, delivering at three maternity hospitals in Berlin, Germany, 2011–2012. Multivariable logistic regression analysis was used to assess immigrant status and other possible risk factors for the baby being delivered preterm, small for gestational age (SGA), or transferred to neonatal care. Results: The final database retained 6702 women, of whom 53.1% were first- or second-generation immigrants. First-generation Turkish immigrant women had significantly lower odds of preterm birth (OR 0.37, P < 0.001), SGA (OR 0.60, P = 0.0079), and transfer of the newborn to neonatal care (OR 0.61, P = 0.0034). Second-generation immigrant women had significantly lower odds of preterm birth (OR 0.67, P = 0.0049) or transfer of the newborn to neonatal care (OR 0.76, P = 0.0312). Moreover, women with education below university level, age 35+, or smokers had higher odds for poor outcomes. Conclusions: This study provides strong evidence that health disparities for obstetric and perinatal health outcomes do not exist in immigrants relative to native Germans, but exist instead in women without post-secondary-level education compared to women with such education, regardless of ethnicity or migration history. © 2017, Springer-Verlag GmbH Germany.

Author Keywords

Pregnancy Perinatal outcomes Immigrant Second-generation immigrant Germany Education level obstetric outcomes

Index Keywords

Germany educational status newborn care immigrant non immigrant health disparity human low risk patient epidemiology Premature Birth statistics and numerical data controlled study premature labor ethnology Humans migrant smoking Infant, Newborn Emigrants and Immigrants female risk factor Risk Factors newborn pregnancy Turk (people) Article obstetric delivery pregnancy outcome Infant, Small for Gestational Age adult major clinical study small for date infant age Turkey prematurity Perinatal Care ethnicity hospital Berlin
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85026899368&doi=10.1007%2fs00404-017-4450-5&partnerID=40&md5=4b31fe9ce525294c88bb881ec7ecd0a1
DOI: 10.1007/s00404-017-4450-5
ISSN: 09320067
Cited by: 5
Original Language: English