Perinatal mortality in non-western migrants in Norway as compared to their countries of birth and to Norwegian women

Abstract

BackgroundA large number of women from countries with a high perinatal mortality rate (PMR) settle in countries with a low PMR. We compared the PMRs for migrants in Norway with the PMRs in their countries of birth. We also assessed the risk of perinatal death in offspring of migrant women as compared to offspring of Norwegian women.MethodsThe Medical Birth Registry of Norway and the Norwegian Central Person Registry provided data on births in Norway during the years 1986 to 2005 among all women born in Norway, Pakistan, Vietnam, Somalia, Sri Lanka, Philippines, Iraq, Thailand and Afghanistan. Information on the PMRs in the countries of birth was obtained from the World Health Organisation (WHO) for the years 1995, 2000 and 2004. Mean PMRs in Norway during 1986–2005 were calculated by mother’s country of birth, and the risks of perinatal death by country of birth were estimated as odds ratios (OR) using Norwegian women as the reference. Adjustments were made for mother’s age, plurality, parity, year of birth and gestational age at birth.ResultsThe PMRs for migrants in Norway were lower than in their countries of birth. The largest difference was in Afghan women (97 deaths per 1000 births in Afghanistan versus 24 deaths per 1000 births in Afghan women in Norway), followed by Iraqi and Somali women. As compared with Norwegian women, the adjusted odds ratio (OR) of perinatal death was highest for Afghan (OR 4.01 CI: 2.40 – 6.71), Somali (OR 1.83 CI: 1.44 - 2.34) and Sri Lankan (OR 1.76 CI: 1.36 – 2.27) women.ConclusionsThe lower PMRs for migrants in Norway as compared to the PMRs in their countries of birth may be explained by access to better health care after migration. The increased risk of perinatal death in migrants as compared to Norwegians encourages further research.

Assimilation effects on infant mortality among immigrants in Norway: Does maternal source country matter?

“…For example, immigrants' diets may be different, and some individuals might be affected by malnutrition (Naimy et al 2013). However, when these immigrants are exposed to the host country environment, they will gradually adopt the behaviours of the native-born population (Antecol and Bedard 2006).…”

“…For example, immigrants who are displaced as a result of war are usually in worse health than the population in the host country (Adanu and Johnson 2009), as they are more likely to be affected by malnutrition and a lack of access to health care services (Naimy et al 2013). This is why, for example, life expectancy and infant mortality vary across countries.…”

“…Hence, international migration to industrialised countries has been accompanied by disparities in the health outcomes of infants born to migrant women and those born to non-migrant women. Previous studies have shown that infant mortality rates depend on the immigrant's destination country, and that different effects are associated with different source countries (Bollini et al 2009;Naimy et al 2013). However, little effort has been made to investigate whether the source country influences the degree of assimilation.…”

Obstetric Outcomes of First- and Second-Generation Pakistani Immigrants: A Comparison Study at a Low-Risk Maternity Ward in Norway

“…The authors concluded that differences between the two immigrant generations persist and that the disparity in health outcomes remains a challenge [16]. However, Naimy et al [20] found that the rate of perinatal mortality among Pakistani immigrants in Norway was lower compared to the rate in their country of origin (i.e., Pakistan).…”

Macroeconomic conditions and population health in Iceland

“…As the immigration legislation in Iceland requires applicants to acquire a medical exam certificate, this would only apply to individuals migrating from exempt countries (Directorate of Immigration n.d.), or asylum seekers from war-torn countries who might suffer from various conditions associated with such circumstances. In addition, infant mortality has been studied in relation to migrants, and previous research has found that infant mortality rates are dependent on both immigrants' country of origin, as well as the destination country (Naimy et al 2013;Kinge and Kornstad 2014;Gissler et al 2009). In contrast to many other economically volatile countries, Iceland is a developed country with a strong data collecting infrastructure, which makes for reliable data.…”