Infant mortality among the Canadian-born offspring of immigrants and non-immigrants in Canada: a population-based study

Abstract

BackgroundAdult immigrants in Canada have a survival advantage over their Canadian-born counterparts. It is unknown whether migrants are able to transmit their survival advantage to their Canadian-born children.MethodsNeonatal and postneonatal mortality between the Canadian-born population and 12 immigrant subgroups were compared using 1990–2005 linked birth-infant death records. Age-at-death specific mortality rates and rate differences were calculated by nativity status and maternal birthplace. A chi-square statistic was used to compare group differences in maternal sociodemographic characteristics. Multivariate survival analysis was used to estimate the effect of maternal birthplace on neonatal and postneonatal mortality, net of maternal sociodemographic and infant characteristics.ResultsOverall, immigrants had lower rates of neonatal and postneonatal mortality than the Canadian-born population. But the adjusted risk of neonatal mortality was higher for Sub-Saharan African (hazard ratio [HR] = 1.32; 95 % confidence interval [CI] = 1.05, 1.66), Haitian (HR = 2.29, 95 % CI = 1.90, 2.76), non-Spanish Caribbean (HR = 1.38; 95 % CI = 1.01, 1.89), and Pakistani (HR = 1.87; 95 % CI = 1.31, 2.68) migrants relative to Canadian-born women. There were fewer significant disparities in postneonatal death, with higher adjusted risks of mortality observed for Pakistani (HR = 2.67, 95 % CI = 1.77, 4.02) and Haitian (HR = 1.41, 95 % CI = 1.02, 1.97) migrants only.ConclusionInequalities in infant mortality are more concentrated in the neonatal period. Contingent on surviving the first 27 days after birth, the infants of most immigrants (except those from Haiti and Pakistan) have the same chances of survival as the infants of Canadian-born women. Improvements in prenatal care and access to postpartum care may reduce disparities in infant mortality.

A Scoping Review of the Health of African Immigrant and Refugee Children

“…Overall, 23 of the articles included in this review examine birth outcomes, with less focus on the reproductive and sexual health of AMC [ 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 ]. A higher prevalence of preterm births is seen in Portugal and Belgium [ 133 , 134 , 135 ], while infant mortality is prevalent in places including Tanzania [ 136 ], Canada [ 137 ], Italy [ 138 ], and South Africa [ 139 ]. Similarly, perinatal mortality in African migrant women is high in Sweden [ 140 ] and Belgium [ 135 ].…”

The contribution of gestational age, area deprivation and mother’s country of birth to ethnic variations in infant mortality in England and Wales: A national cohort study using routinely collected data

“…On the other hand, neither preterm birth nor area deprivation, together with other maternal sociodemographic characteristics, explained the increased risks observed in the South Asian groups, in particular the Pakistani group. International studies also show that Pakistani infants have one of the highest infant mortality rates in other host countries [ 5 , 6 ]. Congenital anomalies are the most common cause of death amongst Pakistani infants [ 7 , 22 ], and risk of infant deaths due to ‘congenital anomalies’ was higher in the Pakistani group than other ethnic groups in our analysis.…”

Immigrant child health in Canada: a scoping review

“…This social determinant of health weaved into greater deprivation indexes that accounted for disparities in help-seeking behaviours. These children presented more frequently to Canadian paediatric emergency departments and faced long wait times when seeking care 86–88. Other social barriers to access in Canada were language, especially for immigrants who were not native English or French speakers, and cultural differences, which fostered mistrust of institutional systems and doubts about provider compassion and competence.…”