Adverse perinatal outcomes among children in Switzerland: the impact of national origin and socio-economic group

Abstract

Objectives We examined the effect of the mother’s origin and socio-economic characteristics on adverse perinatal outcomes in Switzerland. Methods Births occurring from 2011 to 2017 were identified in the Swiss population register and merged with the Swiss civil register and the Register of the first pillar to obtain information on the migration origin and socio-economic level. Four indicators of adverse perinatal outcomes were defined. Results Logistic regressions show that both the migration origin and the socio-economic level are measured by the parents’ income, influence risk. Compared to the children of mothers born in Switzerland, those of mothers from EU/EFTA countries have a lower risk of infant mortality, low birth weight and extreme prematurity. The highest risk is observed for children born to mothers from the rest of the world. High levels of risk consistently characterize children with low-income parents (first decile). Conclusions Our results justify further investigations at the level of health services to better identify the factors causing differences in the prevalence of adverse outcomes and to take them into account in adapted health policies.

Sociodemographic and regional differences in neonatal and infant mortality in Switzerland: The Swiss National Cohort

“…For example, a vital statistics analysis reported for 1980-2011, 29% higher NMR and up to 18% higher IMR among children with non-Swiss nationalities [6]. A follow-up study for 2011-2017 linked live births, infant deaths, and parental income from the Swiss Central Compensation Office [5] and found increased risk for infants of mothers with low-income. Associations with maternal country of birth were less clearcut: IMR was lower for mothers born in EU or EFTA (OR 0.83, 95% CI: 0.71-0.97) and higher (OR 1.15, 95% CI: 1.01-1.30) if born in non-OECD countries.…”

“…We previously reported significant spatial variations of birth weight and gestational age in Switzerland, which language region mainly explained, along with additional urbanization, parental nationality, civil status, and altitude [4]. Other studies from Switzerland—focused on parental income and migrant status—showed increased mortality among infants of parents with low incomes, yet reduced risks if mothers originated from European Union (EU) or European Free Trade Association (EFTA) countries compared with Swiss-born mothers [5, 6]. Until now, other social and regional determinants of infant mortality remained uninvestigated in Switzerland.…”

Effect of covering perinatal health-care costs on neonatal outcomes in Switzerland: a quasi-experimental population-based study

“…1,21,22 In a large observational study using administrative data on births between 2011 and 2017 in Switzerland, offspring of low-income (vs high-income) parents, of women aged 35 years and older (vs 20-34 years), or of mothers from countries outside the European Economic Area (EEA) and OECD (vs Switzerland) were at higher risk of adverse outcomes including low birthweight, preterm birth, and infant mortality. 23 Also, children of women from non-EEA-OECD countries (vs Switzerland) had a similar probability of dying within 1 year from birth in 2015-17…”

“…See Online for appendix (after the policy implementation) compared with a higher probability in 2011-14 (before the policy implementation). 23 However, this study was not designed to estimate the effect of the 2014 health policy expansion on neonatal health outcomes. Therefore, we did a quasiexperimental study using a regression discontinuity design to assess whether full coverage of illness-related costs during pregnancy and for 8 weeks postpartum improves health outcomes in newborn babies in Switzerland.…”

Effectiveness of Theory of Planned Behavior-Based Educational Intervention on Newborn Care in Pregnant Mothers: A Quasi-experimental Study

“…In developed countries, including the United States, two-thirds of all deaths during the first year of life occur in infancy. The annual mortality rate in the first year of life is higher than in the seventh decade of life (4,5). In Iran, the infant mortality rate (IMR) is 12, and the mortality rate in children aged 1-4 years were estimated to be 14.5 per 1000 live births (6,7).…”