Ethnic disparity in severe acute maternal morbidity: a nationwide cohort study in the Netherlands

Abstract

Non-Western immigrants have an increased risk of developing SAMM as compared to Western women. Risks varied largely by ethnic origin. Immigration-related characteristics might partly explain the increased risk. The results suggest that there are opportunities for quality improvement by targeting specific disadvantaged groups.

Increased risk of severe maternal morbidity (near‐miss) among immigrant women in Sweden: a population register‐based study

“…In the Dutch LEMMoN study, women from Morocco and Turkey had no increased risk for severe maternal morbidity, whereas a 3.5-fold increased risk was seen for sub-Saharan African women. 7 Hence division of native countries into low-, middle-and high-income provides a picture of obstetric vulnerability that might not be as clear when looking at individual countries or regions. The total frequency of maternal near-miss that we found, 2.9 per 1000 deliveries, was relatively low compared with other studies.…”

“…5 In previous studies ethnicity was commonly based on either a woman's self-definition of ethnic affiliation, 6 or the country where she or her parents were born. 7 The latter is often further subdivided into local geographical regions.…”

Severe maternal morbidity in ectopic pregnancy is not associated with maternal factors but may be associated with quality of care

“…Data on the number of women from ethnic minorities, ability to communicate in Dutch, and level of home support were available only for the case subjects. In the LEMMoN study, ethnicity was an important risk factor for combined severe maternal morbidity, with a 3.5-fold (95% CI 2.8-4.3) increased risk for sub-Saharan African women (16).…”

Care of the migrant obstetric population

“…27 Ethnic variations in severe maternal morbidity are also reported in the USA and the Netherlands where asylum seekers were at particularly high risk. [28][29][30] These findings led to recommendations that 'tailored' maternity services and improved access should be developed for ethnic minority women. 1 Data from the Centre for Maternal and Child Enquiries (CMACE) covering the period 2000-2008 show major reduction in maternal mortality for black Africans from 72.1 to 32.8/100000 maternities but remains considerably higher than white British/ Irish women (Fig.…”