Risk of stillbirth and preterm birth among undocumented pregnant migrant women in Denmark: A retrospective case-control study

Abstract

Aims: To examine the associations between undocumented pregnant migrant women and the risk of experiencing stillbirth or preterm birth. Methods: A retrospective case–control study based on nationwide registers from Statistics Denmark and hospital journals from the seven largest hospital wards in Denmark from 1 January 2011 to 31 December 2018. A total of 882 undocumented pregnant migrant women and 3528 matched controls (both documented migrant and non-migrant women) were included. Logistic regression models were used to estimate the risk of undocumented pregnant migrant women experiencing (a) stillbirth and (b) preterm birth compared with the control group. Results: Of the undocumented pregnant migrant women, 33.3% were EU citizens, 16.2% were applicants for residence and 50.5% had an unknown basis for residence. The mean age of the undocumented pregnant migrant women was 28.4 years, whereas the mean age of women in the control group was 30.9 years. Higher adjusted odds of experiencing stillbirth (aOR 3.50; 95% CI 1.31–9.38) and preterm birth (aOR 1.41; 95% CI 1.04–1.93) were observed among the undocumented pregnant migrant women compared with the control group. The basis of residence was not associated with higher odds of experiencing stillbirth or preterm birth. Conclusions: We found a higher risk of stillbirth and preterm birth among the undocumented pregnant migrant women than in the control group. Our findings suggest a need to increase the focus on providing access to antenatal care among those women currently excluded from this care.

The effect of limited access to antenatal care on pregnancy experiences and outcomes among undocumented migrant women in Europe: a systematic review

“…One study from Denmark found that UMs were at a higher risk of stillbirth and preterm birth than the control group. A higher adjusted odd of experiencing stillbirth (aOR 3.50; 95% CI 1.31–9.38) and preterm birth (aOR 1.41; 95% CI 1.04–1.93) were observed among the undocumented pregnant migrant women compared with the control group ( 20 ) whereas ( 23 ), in their study uncovered no preterm deliveries (<37.0), low birth weight babies (<2,500 g), nor stillbirths. The rates were higher for preterm birth (RR 1.47, 95% CI 1.21–1.79 and RD 19.3, 95% CI 7.6–13.0 per 1,000 births), and low birth weight (RR 1.36, 95% CI 1.11–1.66 and RD 15.9, 95% CI 3.9–28.0 per 1,000 births) among UMs in Sweden compared to their Swedish counterparts ( 24 ).…”

“…Several studies ( 13 , 15 – 18 ) have highlighted exactly how limited, substandard, or unavailable maternal services are for UMs and what the barriers are to accessing these services in various European countries. Some studies have gone further to explore how UMs utilise the skeletal maternal services available ( 14 , 19 ); and to investigate the experiences or maternal health outcomes of this target population ( 17 , 20 , 21 ). However, there exists a scarcity of research detailing exactly how limited access to ANC affects the pregnancy experiences of UMs living in Europe and the long-term impacts.…”