BMC Pregnancy and Childbirth
Volume 19, Issue 1, 2019

Are preterm birth and intra-uterine growth restriction more common in Western Australian children of immigrant backgrounds? A population based data linkage study (Article) (Open Access)

Abdullahi I. , Wong K. , Glasson E. , Mutch R. , De Klerk N. , Downs J. , Cherian S. , Leonard H.*
  • a Telethon Kids Institute, University of Western Australia, PO Box 855, West Perth, WA 6872, Australia, School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia
  • b Telethon Kids Institute, University of Western Australia, PO Box 855, West Perth, WA 6872, Australia
  • c Telethon Kids Institute, University of Western Australia, PO Box 855, West Perth, WA 6872, Australia
  • d Telethon Kids Institute, University of Western Australia, PO Box 855, West Perth, WA 6872, Australia, School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia, Department of General Paediatrics, Perth Children's Hospital, Perth, WA, Australia
  • e Telethon Kids Institute, University of Western Australia, PO Box 855, West Perth, WA 6872, Australia
  • f Telethon Kids Institute, University of Western Australia, PO Box 855, West Perth, WA 6872, Australia, School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
  • g School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia, Department of General Paediatrics, Perth Children's Hospital, Perth, WA, Australia
  • h Telethon Kids Institute, University of Western Australia, PO Box 855, West Perth, WA 6872, Australia

Abstract

Background: To compare the prevalence of preterm birth, post term birth, intra-uterine growth restriction and distribution of Apgar scores in offspring of foreign-born women in Western Australia with that of their Australian-born non-Indigenous and Indigenous counterparts. Methods: A population-based linked data study, involving 767,623 singleton births in Western Australia between 1980 and 2010 was undertaken. Neonatal outcomes included preterm birth, post term births, intra-uterine growth restriction (assessed using the proportion of optimal birth weight) and low Apgar scores. These were compared amongst foreign-born women from low, lower-middle, upper middle and high income countries and Australian-born non-Indigenous and Indigenous women over two different time periods using multinomial logistic regression adjusted for covariates. Results: Compared with Australian born non-Indigenous women, foreign-born women from low income countries were at some increased risk of extreme preterm (aRRR 1.59, 95% CI 0.87, 2.89) and very early preterm (aRRR 1.63, 95% CI 0.92, 2.89) births during the period from 1980 to 1996. During the period from 1997 to 2010 they were also at some risk of extreme preterm (aRRR 1.42, 95% CI 0.98, 2.04) very early preterm (aRRR 1.34, 95% CI 1.11, 1.62) and post term birth (aRRR 1.93, 95% CI 0.99, 3.78). During this second time period, other adverse outcomes for children of foreign-born women from low income and middle income countries included increases in severe (aRRR 1.69, 95% CI 1.30, 2.20; aRRR 1.72, 95% CI 1.53, 1.93), moderate (aRRR 1.54, 95% CI 1.32, 1.81; aRRR 1.59, 95% CI 1.48, 1.70) and mild (aRRR 1.28, 95% CI 1.14, 1.43; aRRR 1.31, 95% CI 1.25, 1.38) IUGR compared to children of Australian-born non-Indigenous mothers. Uniformly higher risks of adverse outcomes were also demonstrated for infants of Indigenous mothers. Conclusions: Our findings illustrate the vulnerabilities of children born to foreign women from low and middle-income countries. The need for exploratory research examining mechanisms contributing to poorer birth outcomes following resettlement in a developed nation is highlighted. There is also a need to develop targeted interventions to improve outcomes for these women and their families. © 2019 The Author(s).

Author Keywords

Immigrant mothers Apgar score Data linkage Growth restriction Preterm birth

Index Keywords

immigrant intrauterine growth retardation human middle income country controlled study premature labor postmaturity Indigenous Australian high income country smoking male female Apgar score high risk population Western Australia prevalence Article major clinical study adult low income country cohort analysis disease severity retrospective study gross national income gestational age
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85070471901&doi=10.1186%2fs12884-019-2437-x&partnerID=40&md5=e4157c4834746e77cda94a851eb932ac
DOI: 10.1186/s12884-019-2437-x
ISSN: 14712393
Original Language: English