Stillbirth and congenital anomalies in migrants in Europe

Andersen, Anne‐Marie Nybo; Gundlund, Anna; Villadsen, Sarah Fredsted

doi:10.1016/j.bpobgyn.2015.09.004

Cited by 26 publications

(23 citation statements)

References 49 publications

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“…Our findings on elevated risk of stillbirths among asylum seekers are consistent with numerous studies in other countries conducted among general migrant or refugee populations [ 6 – 8 ]. Using the German perinatal data base, Reeske et al reported an increased risk of stillbirths in migrants (without reference to their residence status) originating from the Middle East and North Africa [ 21 ].…”

Section: Discussionsupporting

confidence: 92%

“…Despite equal legal access to health care, pregnant asylum seekers may face numerous barriers to maternity care as a result of limited availability of specialized services in reception centers as well as geographical and language barriers to accessing regular health services outside reception centers [ 4 , 5 ]. Adverse living conditions and health system factors of the country of origin, negative experiences and stressors during the peri-migration phase, as well as structural factors related to reception in destination countries may also put asylum seeking pregnant women at high risk of adverse birth outcomes [ 6 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Differences in pregnancy outcomes and obstetric care between asylum seeking and resident women: a cross-sectional study in a German federal state, 2010–2016

Bozorgmehr

Biddle

Preussler

et al. 2018

BMC Pregnancy Childbirth

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BackgroundDespite large numbers of asylum seekers, there is a lack of evidence on pregnancy outcomes and obstetric care of asylum seeking women in Germany.MethodsCross-sectional study (2010–2016) using administrative data of the main referral hospital for pregnant asylum seekers of the reception center of a large federal state in South Germany. Inclusion criteria: women aged 12–50 years, admitted in relation to pregnancy, childbirth or post-partum complications. Outcomes: differences between asylum seekers and residents in the prevalence of high-risk pregnancy conditions, abortive outcomes/stillbirths, peri- and postnatal maternal complications, neonatal complications, and caesarean sections. Analysis: odds ratios (OR) and 95% confidence intervals (CI) obtained by single and multiple logistic regression analysis. Attributable fractions among the exposed (Afe) and among the total population (Afp) were calculated for selected outcomes.ResultsOf 19,864 women admitted in relation to pregnancy, childbirth or post-partum complications, 2.9% (n = 569) were asylum seekers. Adjusted odds for high-risk pregnancy conditions (OR = 0.76, 95%CI: 0.63–0.91, p < 0.0001), caesarean sections (OR = 0.84, 95%CI 0.66–1.07, p = 0.17) and perinatal complications (OR = 0.65, 95%CI: 0.55–0.78, p < 0.0001) were lower; those for abortive outcomes/stillbirths (OR = 1.58, 95%CI: 1.11–2.20, p = 0.01) and postnatal complications (OR = 1.80, 95%CI: 0.93–3.19, p = 0.06) higher among asylum seeking women relative to residents in models adjusted for age, length of admission, and high-risk pregnancy conditions. The Afe for abortive outcomes and stillbirths among asylum seekers was 40.3% (95% CI, 16.3–56.5) and the Afp was 1.8%. The Afe for postnatal complications was 53.1% (95% CI, 7.1–74.0) and the Afp was 3.1%.ConclusionAsylum seeking women are at higher risk of abortive outcomes/stillbirths and show a tendency towards higher postnatal complications. This excess risk calls for adequate responses by health care providers and policy makers to improve outpatient postnatal care in reception centers and mitigate adverse birth outcomes among asylum seeking women. Although further research is needed, scaling-up midwivery care, improving outreach by maternity care teams, and routinely identifying and addressing mental illness by psychosocial services could be ways forward to improve outcomes in this population.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-2053-1) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Differences in pregnancy outcomes and obstetric care between asylum seeking and resident women: a cross-sectional study in a German federal state, 2010–2016

Bozorgmehr

Biddle

Preussler

et al. 2018

BMC Pregnancy Childbirth

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“…In other words, health inequality monitoring reveals which subgroups within a population perform well when it comes to health and which perform less well. In the example of infant health, across European countries, adverse infant outcomes and mortality were found to be elevated among babies born to migrant parents compared to babies born to parents who are not migrants (Andersen et al 2016). The rate of cancer mortality in Spain was variable across different areas of the country, and even within cities, urban areas with high levels of socioeconomic deprivation were found to have excess cancer mortality compared to urban areas with lower socioeconomic deprivation (Puigpinos-Riera et al 2011).…”

Section: Setting the Scenementioning

confidence: 99%

Health Inequality Monitoring: A Practical Application of Population Health Monitoring

Hosseinpoor

Bergen

2018

Population Health Monitoring

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“…Sensitivity analyses. Analyses were undertaken by excluding SBs with major anomalies from the analysis because of potential restricted access or differing attitudes to screening or termination of pregnancy reported for some ethnic backgrounds [30,53].…”

Section: Plos Medicinementioning

confidence: 99%

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

2020

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Background Migrant women, especially from Indian and African ethnicity, have a higher risk of stillbirth than native-born populations in high-income countries. Differential access or timing of ANC and the uptake of other services may play a role. We investigated the pattern of healthcare utilisation among migrant women and its relationship with the risk of stillbirth (SB)-antepartum stillbirth (AnteSB) and intrapartum stillbirth (IntraSB)-in Western Australia (WA). Methods and findings A retrospective cohort study using de-identified linked data from perinatal, birth, death, hospital, and birth defects registrations through the WA Data Linkage System was undertaken. All (N = 260,997) non-Indigenous births (2005-2013) were included. Logistic regression analysis was used to estimate odds ratios and 95% CI for AnteSB and IntraSB comparing migrant women from white, Asian, Indian, African, Māori, and 'other' ethnicities with Australian-born women controlling for risk factors and potential healthcare-related covariates. Of all the births, 66.1% were to Australian-born and 33.9% to migrant women. The mean age (years) was 29.5 among the Australian-born and 30.5 among the migrant mothers. For parity, 42.3% of Australian-born women, 58.2% of Indian women, and 29.3% of African women were nulliparous. Only 5.3% of Māori and 9.2% of African migrants had private health insurance in contrast to 43.1% of Australian-born women. Among Australian-born women, 14% had smoked in pregnancy whereas only 0.7% and 1.9% of migrants from Indian and African backgrounds, respectively, had smoked in pregnancy. The odds of AnteSB was elevated in African (odds ratio [

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Stillbirth and congenital anomalies in migrants in Europe

Cited by 26 publications

References 49 publications

Differences in pregnancy outcomes and obstetric care between asylum seeking and resident women: a cross-sectional study in a German federal state, 2010–2016

Differences in pregnancy outcomes and obstetric care between asylum seeking and resident women: a cross-sectional study in a German federal state, 2010–2016

Health Inequality Monitoring: A Practical Application of Population Health Monitoring

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

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