Association between Migrant Women’s Legal Status and Prenatal Care Utilization in the PreCARE Cohort

Eslier, Maxime; Deneux‐Tharaux, Catherine; Sauvegrain, Priscille; Schmitz, Thomas; Luton, Dominique; Mandelbrot, Laurent; Estellat, Candice; Azria, Élie

doi:10.3390/ijerph17197174

Cited by 19 publications

(24 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Differences in how immigrants are defined in each society, as well as the legal status of the immigrant population may be a challenge to access healthcare services. These may be extrapolated to prenatal care utilization, both by its timing and its content [ 163 ], which subsequently impact on the risk of adverse outcomes among pregnant women with the immigration background. Additionally, it is argued that misconceptions between healthcare providers and immigrant women through different cultural concepts and acceptability of care, or more directly through lack of interpretation services may affect pregnancy outcomes [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis

Behboudi‐Gandevani

Panahi

Mardani

et al. 2022

Annals of Global Health

View full text Add to dashboard Cite

Background: Disparities in health outcomes between immigrant and native-origin populations, particularly pregnant women, pose significant challenges to healthcare systems. The aim of this systematic-review and meta-analysis was to investigate the risk of adverse pregnancy outcomes among immigrant-women compared to native-origin women in the host country.Methods: PubMed (including MEDLINE), Scopus, and Web of Science were searched to retrieve studies published in English language up to September 2020. All observational studies examining the prevalence of at least one of the short-term single pregnancy outcomes for immigrants who crossed international borders compared to native-origin pregnant population were included. The meta-prop method was used for the pooledestimation of adverse pregnancy-outcomes' prevalence. For pool-effect estimates, the association between the immigration-status and outcomes of interest, the randomeffects model was applied using the model described by DerSimonian and Laird. I 2 statistic was used to assess heterogeneity. The publication bias was assessed using the Harbord-test. Meta-regression was performed to explore the effect of geographical region as the heterogeneity source.Findings: This review involved 11 320 674 pregnant women with an immigrationbackground and 56 102 698 pregnant women as the native-origin population. The risk of emergency cesarean section (Pooled-OR = 1.1, 95%CI = 1.0-1.2), shoulder dystocia (Pooled-OR = 1.1, 95%CI = 1.0-1.3), gestational diabetes mellites (Pooled-OR = 1.4, 95%CI = 1.2-1.6), small for gestational age (Pooled-OR=1.3, 95%CI = 1.1-0.4), 5-min Apgar less than 7 (Pooled-OR = 1.2, 95%CI = 1.0-1.3) and oligohydramnios (Pooled-OR = 1.8, 95%CI = 1.0-3.3) in the immigrant women were significantly higher than those with the native origin background. The immigrant women had a lower risk of labor induction (Pooled-OR = *Author affiliations can be found in the back matter of this article 2 Behboudi-Gandevani et al.

show abstract

Section: Discussionmentioning

confidence: 99%

Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis

Behboudi‐Gandevani

Panahi

Mardani

et al. 2022

Annals of Global Health

View full text Add to dashboard Cite

show abstract

“…Our findings of a poor understanding of information among refugees may partially explain insufficient access and utilisation of antenatal care within this subgroup of migrants [ 4 , 41 ]. The majority language proficiency is undoubtedly an important factor in understanding information, as confirmed by other studies [ 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…Disparities in maternal health outcomes and sub-optimal healthcare for migrants in Europe have been well documented [ 2 , 3 ]. Migrants have poorer access to, and inadequate utilisation of, available maternity healthcare services, which may be associated with socioeconomic status and the reason for migration [ 4 ]. Furthermore, women born in low- or middle-income countries represent a group with a higher risk-profile and in need of healthcare during pregnancy and birth [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Newly Arrived Migrant Women’s Experience of Maternity Health Information: A Face-to-Face Questionnaire Study in Norway

Bains

Sundby

Lindskog

et al. 2021

IJERPH

View full text Add to dashboard Cite

Limited understanding of health information may contribute to an increased risk of adverse maternal outcomes among migrant women. We explored factors associated with migrant women’s understanding of the information provided by maternity staff, and determined which maternal health topics the women had received insufficient coverage of. We included 401 newly migrated women (≤5 years) who gave birth in Oslo, excluding migrants born in high-income countries. Using a modified version of the Migrant Friendly Maternity Care Questionnaire, we face-to-face interviewed the women postnatally. The risk of poor understanding of the information provided by maternity staff was assessed in logistic regression models, presented as adjusted odds ratios (aORs), with 95% confidence intervals (CI). The majority of the 401 women were born in European and Central Asian regions, followed by South Asia and North Africa/the Middle East. One-third (33.4%) reported a poor understanding of the information given to them. Low Norwegian language proficiency, refugee status, no completed education, unemployment, and reported interpreter need were associated with poor understanding. Refugee status (aOR 2.23, 95% CI 1.01–4.91), as well as a reported interpreter need, were independently associated with poor understanding. Women who needed but did not get a professional interpreter were at the highest risk (aOR 2.83, 95% CI 1.59–5.02). Family planning, infant formula feeding, and postpartum mood changes were reported as the most frequent insufficiently covered topics. To achieve optimal understanding, increased awareness of the needs of a growing, linguistically diverse population, and the benefits of interpretation services in health service policies and among healthcare workers, are needed.

show abstract

“…One hypothesis that might explain this result is that antenatal care utilisation was inadequate in both quantity and quality. A previous analysis of this study has reported this inadequacy to be more prevalent among undocumented women 27 . This higher risk of inadequate antenatal care utilisation might be explained by the shorter residence and the greater frequency of linguistic barriers, social isolation and poor housing conditions among these women, compared with other categories of migrants.…”

Section: Discussionmentioning

confidence: 47%

Severe maternal morbidity among undocumented migrant women in the PreCARE prospective cohort study

Eslier

Deneux‐Tharaux

Sauvegrain

et al. 2022

BJOG

Self Cite

View full text Add to dashboard Cite

Objective: To assess the risk of severe maternal outcomes among migrant women, considering both their legal status and birthplace; in Europe, migrant women, especially from sub-Saharan Africa, have higher risks of adverse maternal outcomes compared with non-migrants and legal status, a component of migrant condition, may be an important, and potentially actionable, risk factor. Design: Prospective cohort study.Setting: Four maternity units around Paris in 2010-12.Sample: A total of 9599 women with singleton pregnancies. Methods: Legal status was categorised in four groups: reference group of nonmigrant native Frenchwomen, legal migrants with French or European citizenship, other legal migrants with non-European citizenship, and undocumented migrants.The risk of severe maternal morbidity was assessed with multivariable logistic regression models according to women's legal status and birthplace.Main outcome measure: Binary composite criterion of severe maternal morbidity.Results: Undocumented migrants had resided for less time in France, experienced social isolation, linguistic barriers and poor housing conditions more frequently and had a prepregnancy medical history at lower risk than other migrants. The multivariable analysis showed that they had a higher risk of severe maternal morbidity than non-migrants (33/715 [4.6%] versus 129/4523 [2.9%]; adjusted odds ratio [aOR] 1.68, 95% CI 1.12-2.53). This increased risk was significant for undocumented women from sub-Saharan Africa (18/308 [5.8%] versus 129/4523 [2.9%]; aOR 2.26, 95% CI 1.30-3.91), and not for those born elsewhere (15/407 [3.7%] versus 129/4523 [2.9%]; aOR 1.44, 95% CI 0.82-2.53). Conclusion:Undocumented migrants are the migrant subgroup at highest risk of severe maternal morbidity, whereas the prevalence of risk factors does not appear to be higher in this subgroup. This finding suggests that their interaction with maternity care services may be sub-optimal. K E Y W O R D Shealth inequalities, legal status, severe maternal morbidity, undocumented migrant Funding informationThis study was supported by grants from the Medical Research Foundation (http://www. frm.org/), French Ministry of Health, PHRC 2007 and PHRC 2012 (http://www.sante.gouv. fr/le-progr amme-hospi talier-de-rechercheclini que-phrc.html). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

show abstract

Association between Migrant Women’s Legal Status and Prenatal Care Utilization in the PreCARE Cohort

Cited by 19 publications

References 34 publications

Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis

Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis

Newly Arrived Migrant Women’s Experience of Maternity Health Information: A Face-to-Face Questionnaire Study in Norway

Severe maternal morbidity among undocumented migrant women in the PreCARE prospective cohort study

Contact Info

Product

Resources

About