Healthcare factors associated with the risk of antepartum and intrapartum stillbirth in migrants in Western Australia (2005-2013): A retrospective cohort study

Mozooni, Maryam; Pennell, Craig E.; Preen, David B.

doi:10.1371/journal.pmed.1003061

Cited by 18 publications

(12 citation statements)

References 61 publications

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“…Genealogical linkage through the Family Connections Linkage Facility of the WADLS [25] was used to link mothers with child records. The details of the datasets used were described elsewhere [6,19].…”

Section: Data Sourcesmentioning

confidence: 99%

“…Similar research is limited in Australia and the impact of acculturation on stillbirth risk is poorly understood; we have previously shown that the migrant population, compared with the Australian-born population, utilise healthcare services differently. Late commencement of antenatal-care visits and lack of access to or uptake of doctorprovided intrapartum-care as well as absence of private health insurance emerged as underlying factors for increased risk of stillbirth in specific ethnic groups in Western Australia (WA) [19]. However, it is not clear whether the risk of stillbirth persists the longer migrants live and interact with the community in Australia.…”

Section: Introductionmentioning

confidence: 99%

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The influence of acculturation on the risk of stillbirth in migrant women residing in Western Australia

2020

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Objective To investigate the influence of acculturation, demonstrated by age on arrival, length of residence, interpreter use and having an Australian-born partner, on disparities observed in the risk of stillbirth between migrant and Australian-born populations in Western Australia (WA). Methods A retrospective cohort study using linked administrative health data for all non-Indigenous births in WA from 2005-2013 was performed. Logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Adjusted odds ratios (aOR) for stillbirth in migrants from six ethnicities of white, Asian, Indian, African, Māori, and 'other', with different levels of acculturation, were compared with Australian-born women using multivariable logistic regression analysis and marital status, maternal age group, socioeconomic status, parity, plurality, previous stillbirth, any medical conditions, any pregnancy complications, sex of baby, and smoking during pregnancy as the covariates. Results From all births studied, 172,571 (66%) were to Australian-born women and 88,395 (34%) to migrant women. Women from African, Indian and Asian backgrounds who gave birth in the first two years after arrival in Australia experienced the highest risk of stillbirth (aOR 3.32; 95% CI 1.70-6.47, aOR 2.71; 95% CI 1.58-4.65, aOR 1.93; 95% CI 1.21-3.05 respectively) compared with Australian-born women. This association attenuated with an increase in the length of residence in Asian and Indian women, but the risk of stillbirth remained elevated in African women after five years of residence (aOR 1.96 [1.10-3.49]). Interpreter use and an Australian-born partner were associated with 56% and 20% lower odds of stillbirth in migrants (p<0.05), respectively.

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Section: Data Sourcesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The influence of acculturation on the risk of stillbirth in migrant women residing in Western Australia

2020

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“…The main characteristics of the selected studies have been outlined in Table 1 . The studies were conducted in Europe ( n = 37; Spain [ 23 , 33 ], Finland [ 25 , 34 ], Israel [ 9 , 15 ], Turkey [ 22 , 24 , 35 – 38 ], Sweden [ 12 , 13 , 39 , 40 ], Norway [ 16 , 19 , 41 – 45 ], Belgium [ 17 , 18 , 45 , 46 ], United Kingdom [ 45 , 47 ], Netherlands [ 20 , 45 ], Denmark [ 45 , 48 ], Switzerland [ 45 ], Austria [ 45 ], Germany [ 45 ] and Italy [ 49 ]), America ( n = 8; Canada [ 21 , 26 , 50 ], USA [ 51 – 53 ] and Argentina [ 4 , 54 ]), Australia ( n = 5) [ 8 , 10 , 11 , 14 , 55 ]), and Taiwan ( n = 1) [ 56 , 57 ]. The results of quality appraisals of the included studies have been summarized in Supplementary Tables S1, S2 .…”

Section: Resultsmentioning

confidence: 99%

“…The results of quality appraisals of the included studies have been summarized in Supplementary Tables S1, S2 . A total of 38 (84%) studies had high [ 4 , 8 – 19 , 21 , 23 , 25 , 26 , 33 – 36 , 39 – 48 , 50 – 53 , 55 – 57 ], 7 (16%) had moderate quality [ 20 , 22 , 24 , 37 , 38 , 49 , 54 ], and no study had low quality.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 31 studies [ 4 , 8 – 13 , 20 – 23 , 26 , 33 – 41 , 43 – 46 , 48 , 49 , 51 , 52 , 55 , 57 ] reported stillbirth in 12,232 out of 2,715,308 immigrant women and 72,100 out of 19,262,686 native-origin women. Although there were statistical significant heterogenicities in the studies (I-squared = 95.5%), no publication bias was found (Harbord test p value = 0.160).…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review and Meta-Analysis of the Risk of Stillbirth, Perinatal and Neonatal Mortality in Immigrant Women

Behboudi‐Gandevani¹,

Panahi²,

Mardani³

et al. 2022

Int J Public Health

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Objectives: This study aimed to investigate the risk of stillbirth, perinatal and neonatal mortality in immigrant women compared to native-origin women in host countries.Methods: A systematic literature review and meta-analysis was conducted. Relevant studies were identified using a thorough literature search and their quality was appraised. The analysis of heterogeneous data was carried out using the random effects model and publication bias was assessed using the Harbord-test. Also, the pooled odds ratio of events was calculated through the DerSimonian and Laird, and inverse variance methods.Results: In the search process 45 studies were retrieved consisting of 8,419,435 immigrant women and 40,113,869 native-origin women. The risk of stillbirth (Pooled OR = 1.35, 95% CI = 1.22–1.50), perinatal mortality (Pooled OR = 1.50, 95% CI = 1.35–1.68), and neonatal mortality (Pooled OR = 1.09, 95% CI = 1.00–1.19) in the immigrant women were significantly higher than the native-origin women in host countries. According to the sensitivity analyses, all results were highly consistent with the main data analysis results.Conclusion: The immigrant women compared to the native-origin women had the higher risks of stillbirth, perinatal and neonatal mortality. Healthcare providers and policy makers should improve the provision of maternal and neonatal healthcare for the immigrant population.

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Impact of health literacy on pregnancy outcomes in socioeconomically disadvantaged and ethnic minority populations: A scoping review

Kim,

Heazell,

Whittaker

et al. 2024

Intl J Gynecology & Obste

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BackgroundHealth literacy, influenced by sociodemographic characteristics such as ethnicity, economic means and societal factors, affects the ways in which pregnant women maintain their health; this in turn may increase risk of adverse pregnancy outcomes.ObjectiveTo explore what is known about the impact of personal health literacy on prevention of stillbirth and related adverse outcomes in pregnant women of low socioeconomic status or from ethnic minority backgrounds.Search StrategyMEDLINE, CINAHL, PsychINFO, and CENTRAL were searched as well as reference lists of included studies and gray literature.Selection CriteriaIncluded studies focused on personal health literacy and stillbirth prevention in women from low socioeconomic or ethnic minority backgrounds in the perinatal period.Data Collection and AnalysisA meta‐summary approach was adopted for qualitative, observational, descriptive, and audit studies. Findings of intervention studies were extracted, and meta‐analyses were conducted where possible. The primary outcome was stillbirth; maternal mortality and neonatal mortality were secondary outcomes.Main ResultsForty‐one studies were included from diverse geographical settings. The meta‐summary synthesized five abstracted statements. These recognized lower personal health literacy and greater difficulty interacting with healthcare services in the studied populations, primarily as the result of limited health knowledge, lack of positive perception towards health services, language barriers, illiteracy, and relying on friends or family members for health information. Meta‐analysis of intervention studies revealed no association between current interventions that aimed to increase personal health literacy and the risk of stillbirth (relative risk [RR] 1.04, 95% confidence interval [CI] 0.96–1.12), neonatal mortality (RR 0.88, 95% CI 0.75–1.03), and maternal mortality (RR 0.87, 95% CI 0.63–1.22).ConclusionsVarious factors suggest lower personal health literacy in women of low socioeconomic status or ethnic minority, which can increase the risk of stillbirth. However, this review identified no significant impact of current health education interventions on the risk of stillbirth, or neonatal or maternal mortality. Although not directly measured, the health education interventions were anticipated to increase personal health literacy. Further research on the topic of this scoping review is warranted, particularly in lower‐resource settings and regarding the potential role of e‐literacy and organizational health literacy to improve pregnancy outcomes. To address deficits in health literacy, efforts must be made to provide pregnant women with health information in novel, accessible ways.

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Healthcare factors associated with the risk of antepartum and intrapartum stillbirth in migrants in Western Australia (2005-2013): A retrospective cohort study

Cited by 18 publications

References 61 publications

The influence of acculturation on the risk of stillbirth in migrant women residing in Western Australia

The influence of acculturation on the risk of stillbirth in migrant women residing in Western Australia

A Systematic Review and Meta-Analysis of the Risk of Stillbirth, Perinatal and Neonatal Mortality in Immigrant Women

Impact of health literacy on pregnancy outcomes in socioeconomically disadvantaged and ethnic minority populations: A scoping review

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