Severe maternal morbidity among undocumented migrant women in the PreCARE prospective cohort study

Eslier, Maxime; Deneux‐Tharaux, Catherine; Sauvegrain, Priscille; Schmitz, Thomas; Luton, Dominique; Mandelbrot, Laurent; Estellat, Candice; Azria, Élie

doi:10.1111/1471-0528.17124

Cited by 14 publications

(7 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Eslier et al ( 21 ) found that undocumented migrants in France had a higher risk of severe maternal morbidity (33/715 [4.6%] vs. 129/4523 [2.9%]; absolute difference 1.7%, 95% CI 0.4%–3.6%; a OR 1.68, 95% CI 1.12–2.53), when compared to the reference group, it was discovered that undocumented migrants had hypertensive problems at least twice as prevalent as non-migrants or legal migrants. However, this study indicated that only undocumented migrants born in sub-Saharan Africa were at a significantly increased risk when considering both their location of birth and their legal status.…”

Section: Resultsmentioning

confidence: 99%

“…These factors such as language and cultural differences, socio-economic conditions, and fear of deportation also double as some of the barriers to accessing ANC. Eslier et al ( 21 ) hypothesised that prenatal care utilisation was inadequate for UMs, both in terms of quantity and quality, and suggested that socioeconomic and language barriers may be to blame for this group of women's underutilisation of ANC services in comparison to non-migrants and other categories of migrants. In spite of the fact that ANC is essential for the detection, monitoring, and treatment of several pregnancy-related health problems, UMs still find it difficult to access their legal rights, making it difficult for them to access and receive care.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Osuide,

Parsa,

Mahmud

et al. 2024

Front. Glob. Womens Health

View full text Add to dashboard Cite

Women who are undocumented migrants in Europe encounter a variety of challenges while trying to access health services, including restricted access to antenatal care (ANC) despite the importance of ANC to the well-being of mothers and their infants. This study's aim was to examine the effect that limited access to antenatal care has on the pregnancy experiences and outcomes of undocumented migrant (UM) women in Europe. Systematic searches were done on PubMed, Ovid MEDLINE, Ovid EMBASE, EBSCO CINAHL Plus, and BioMed Central. From the search results, only primary research articles that reported on the pregnancy outcomes and experiences of undocumented migrants were selected. A meta-analysis was not possible because this review included information from both qualitative and quantitative studies. The data that was taken from the included publications was organised, analysed, using the Microsoft Excel programme, and then meta-synthesised. Twelve papers from seven different European nations—Belgium, France, Sweden, Denmark, Norway, Finland, and England—were included in this systematic review. Eight of the studies aimed to explore the access to and utilization of ANC by undocumented migrant women and the related pregnancy outcomes. Two of the included studies examined the pregnancy experiences of UMs and two examined the perinatal risks associated with living as a migrant with no legal status. Although heterogeneous in their specific findings most of the studies showed undocumented immigrants are more likely to experience unfavourable pregnancy outcomes and experience greater anxiety and worries due to a variety of factors than documented migrants and registered citizens. This review's conclusions demonstrate the pressing need for policy modifications and healthcare reforms in Europe to address the problems associated with undocumented migrants’ restricted access to antenatal care. It also highlights the urgent need for structural changes that will give this vulnerable population's health and well-being a higher priority. It is not just an issue of health equality but also a humanitarian obligation to address the many obstacles and difficulties undocumented migrant women endure during pregnancy.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Osuide,

Parsa,

Mahmud

et al. 2024

Front. Glob. Womens Health

View full text Add to dashboard Cite

show abstract

“…In contrast to previous systematic reviews, we have included all data available from high-income countries and not only those in Europe [8,35]. This offers the opportunity to compare national contexts with various migration demographic patterns, as well as various [31] and 2022 [64]; Wahlberg et al 2013 [72]; Zwart et al 2008 [9], 2010 [65] and 2011 [66]; Van Hanegem et al 2011 [67]; Urquia et al 2015 [40] and 2017 [15]. CI, confidence interval; df, degrees of freedom; IV, inverse variance; RR, risk ratio.…”

Section: Plos Medicinementioning

confidence: 99%

Association between migration and severe maternal outcomes in high-income countries: Systematic review and meta-analysis

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background Literature focusing on migration and maternal health inequalities is inconclusive, possibly because of the heterogeneous definitions and settings studied. We aimed to synthesize the literature comparing the risks of severe maternal outcomes in high-income countries between migrant and native-born women, overall and by host country and region of birth. Methods and findings Systematic literature review and meta-analysis using the Medline/PubMed, Embase, and Cochrane Library databases for the period from January 1, 1990 to April 18, 2023. We included observational studies comparing the risk of maternal mortality or all-cause or cause-specific severe maternal morbidity in high-income countries between migrant women, defined by birth outside the host country, and native-born women; used the Newcastle–Ottawa scale tool to assess risk of bias; and performed random-effects meta-analyses. Subgroup analyses were planned by host country and region of birth. The initial 2,290 unique references produced 35 studies published as 39 reports covering Europe, Australia, the United States of America, and Canada. In Europe, migrant women had a higher risk of maternal mortality than native-born women (pooled risk ratio [RR], 1.34; 95% confidence interval [CI], 1.14, 1.58; p < 0.001), but not in the USA or Australia. Some subgroups of migrant women, including those born in sub-Saharan Africa (pooled RR, 2.91; 95% CI, 2.03, 4.15; p < 0.001), Latin America and the Caribbean (pooled RR, 2.77; 95% CI, 1.43, 5.35; p = 0.002), and Asia (pooled RR, 1.57, 95% CI, 1.09, 2.26; p = 0.01) were at higher risk of maternal mortality than native-born women, but not those born in Europe or in the Middle East and North Africa. Although they were studied less often and with heterogeneous definitions of outcomes, patterns for all-cause severe maternal morbidity and maternal intensive care unit admission were similar. We were unable to take into account other social factors that might interact with migrant status to determine maternal health because many of these data were unavailable. Conclusions In this systematic review of the existing literature applying a single definition of “migrant” women, we found that the differential risk of severe maternal outcomes in migrant versus native-born women in high-income countries varied by host country and region of origin. These data highlight the need to further explore the mechanisms underlying these inequities. Trial Registration PROSPERO CRD42021224193.

show abstract

“…Although the performance of this screening has not been evaluated in pregnant women, the French Health Authority has recommended since 2007 Pap tests for all woman at the beginning of pregnancy if their last test took place more than three years earlier [ 30 ]. Maternal health inequalities according to maternal place of birth have been described in high-income countries, specifically in France [ 31 , 32 ]. It is important to know if these inequalities also affect cervical cancer screening during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Women’s country of birth and failure to catch up an overdue cervical cancer cytological screening participation during pregnancy in France, an observational study based on survey sources

Lyonnais,

Vigoureux,

Blondel

et al. 2024

BMC Cancer

Self Cite

View full text Add to dashboard Cite

Background Cervical cancer is the fourth most common cancer among women worldwide, both for incidence and mortality. Prevention relies on screening with a Pap test to detect precancerous lesions, which can then be treated. Access to this screening is currently both improvable and inequitable. Pregnancy may be an ideal moment for women to catch up on their overdue cervical cancer screening. In the general population, women's risk of not being screened is associated with their place of birth and other social factors; this may be true as well among pregnant women. Our objective was to study the association between women's place of birth and their failure to catch up with this screening during pregnancy. Methods The 2016 French National Perinatal Survey included 13,147 women who gave birth after 21 weeks of gestation. The association between their place of birth and failure to catch up on this screening (defined by the absence of a Pap test during pregnancy for women overdue for it) was adjusted for age, parity, education level, health insurance, and when they began prenatal care with logistic regression models. Results Among the women for whom screening was then recommended, 49% were not up to date at the start of pregnancy, and of these, 53% were not caught up before delivery. After adjustment for other risk factors, maternal place of birth was not associated with a higher risk of failure to catch up with this screening during pregnancy. However, factors identified as associated with this risk included a low education level and late start of prenatal care. Conclusion About half of women overdue for cervical cancer screening did not catch up with it during their pregnancy. Professionals should pay special attention to women with lower education levels and late initiation of prenatal care, who constitute a group at high risk of not catching up on this screening during pregnancy.

show abstract

Severe maternal morbidity among undocumented migrant women in the PreCARE prospective cohort study

Cited by 14 publications

References 26 publications

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

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

Association between migration and severe maternal outcomes in high-income countries: Systematic review and meta-analysis

Women’s country of birth and failure to catch up an overdue cervical cancer cytological screening participation during pregnancy in France, an observational study based on survey sources

Contact Info

Product

Resources

About