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Maternal Health and Pregnancy Outcomes Comparing Migrant Women Born in Humanitarian and Nonhumanitarian Source Countries: A Retrospective, Observational Study
Author(s) -
GibsonHelm Melanie E.,
Teede Helena J.,
Cheng IHao,
Block Andrew A.,
Knight Michelle,
East Christine E.,
Wallace Euan M.,
Boyle Jacqueline A.
Publication year - 2015
Publication title -
birth
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.233
H-Index - 83
eISSN - 1523-536X
pISSN - 0730-7659
DOI - 10.1111/birt.12159
Subject(s) - medicine , pregnancy , obstetrics , observational study , low birth weight , gestation , body mass index , genetics , biology
Background The relationship between migration and pregnancy outcomes is complex, with little insight into whether women of refugee background have greater risks of adverse pregnancy outcomes than other migrant women. This study aimed to describe maternal health, pregnancy care, and pregnancy outcomes among migrant women from humanitarian and nonhumanitarian source countries. Methods Retrospective, observational study of singleton births, at a single maternity service in Australia 2002–2011, to migrant women born in humanitarian source countries ( HSC s, n = 2,713) and non‐ HSC s ( n = 10,606). Multivariable regression analysis assessed associations between maternal HSC ‐birth and pregnancy outcomes. Results Compared with women from non‐ HSC s, the following were more common in women from HSC s: age < 20 years (0.6 vs 2.9% p < 0.001), multiparity (51 vs 76% p < 0.001), body mass index (BMI) ≥ 25 (38 vs 50% p < 0.001), anemia (3.2 vs 5.9% p < 0.001), tuberculosis (0.1 vs 0.4% p = 0.001), and syphilis (0.4 vs 2.5% p < 0.001). Maternal HSC ‐birth was independently associated with poor or no pregnancy care attendance ( OR 2.5 [95% CI 1.8–3.6]), late first pregnancy care visit ( OR 1.3 [95% CI 1.1–1.5]), and postterm birth (> 41 weeks gestation) (OR 2.5 [95% CI 1.9–3.4]). Stillbirth (0.8 vs 1.2% p = 0.04, OR 1.5 [95% CI 1.0–2.4]) and unplanned birth before arrival at the hospital (0.6 vs 1.2% p < 0.001, OR 1.3 [95% CI 0.8–2.1]) were more common in HSC ‐born women but not independently associated with maternal HSC ‐birth after adjusting for age, parity, BMI and relative socioeconomic disadvantage. Conclusions These findings suggest areas where women from HSC s may have additional needs in pregnancy compared with women from non‐ HSC s. Refugee‐focused strategies to support engagement in pregnancy care and address maternal health needs would be expected to improve health outcomes in resettlement countries.