Perinatal outcome of immigrant women with and without refugee status compared to non-immigrant women: results of the pregnancy and obstetric care for refugees (PROREF) cross-sectional study.
Immigrant health
Maternal health
Migrant questionnaire
Obstetric care
Perinatal health
Refugee health
Social determinants of health
Journal
Archives of gynecology and obstetrics
ISSN: 1432-0711
Titre abrégé: Arch Gynecol Obstet
Pays: Germany
ID NLM: 8710213
Informations de publication
Date de publication:
16 Aug 2024
16 Aug 2024
Historique:
received:
05
06
2024
accepted:
05
07
2024
medline:
16
8
2024
pubmed:
16
8
2024
entrez:
16
8
2024
Statut:
aheadofprint
Résumé
International studies show conflicting evidence regarding the perinatal outcome of immigrant women with and without refugee status compared to non-immigrant women. There are few studies about the situation in Germany. The research question of this article is: Is the perinatal outcome (Apgar, UApH (umbilical artery pH), NICU (neontatal intensive care unit) transfer, c-section rate, preterm birth, macrosomia, maternal anemia, higher degree perinatal tear, episiotomy, epidural anesthesia) associated with socio-demographic/clinical characteristics (migration status, language skills, household income, maternal education, parity, age, body mass index (BMI))? In the Pregnancy and Obstetric Care for Refugees (PROREF)-study (subproject of the research group PH-LENS), funded by the German Research Foundation (DFG), women giving birth in three centers of tertiary care in Berlin were interviewed with the modified Migrant Friendly Maternity Care Questionnaire between June 2020 and April 2022. The interview data was linked to the hospital charts. Data analysis was descriptive and logistic regression analysis was performed to find associations between perinatal outcomes and migration data. During the research period 3420 women (247 with self-defined (sd) refugee status, 1356 immigrant women and 1817 non-immigrant women) were included. Immigrant women had a higher c-section rate (36.6% vs. 33.2% among non-immigrant women and 31.6% among women with sd refugee status, p = 0.0485). The migration status did not have an influence on the umbilical artery pH, the preterm delivery rate and the transfer of the neonate to the intensive care unit. Women with self-defined refugee status had a higher risk for anemia (31.9% vs. 26.3% immigrant women and 23.4% non-immigrant women, p = 0.0049) and were less often offered an epidural anesthesia for pain control during vaginal delivery (42.5% vs. 54% immigrant women and 52% non-immigrant women, p = 0.0091). In the multivariate analysis maternal education was explaining more than migration status. Generally, the quality of care for immigrant and non-immigrant women in Berlin seems high. The reasons for higher rate of delivery via c-section among immigrant women remain unclear. Regardless of their migration status women with low degree of education seem at increased risk for anemia.
Identifiants
pubmed: 39150503
doi: 10.1007/s00404-024-07639-3
pii: 10.1007/s00404-024-07639-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Deutsche Forschungsgemeinschaft
ID : DA 1199/5-1
Organisme : Deutsche Forschungsgemeinschaft
ID : BO 3384/2-1
Informations de copyright
© 2024. The Author(s).
Références
Ravelli AC, Tromp M, Eskes M, Droog JC, van der Post JA, Jager KJ, Reitsma JB (2011) Ethnic differences in stillbirth and early neonatal mortality in The Netherlands. J Epidemiol Commun Health 65(8):696–701
doi: 10.1136/jech.2009.095406
Gould JB et al (2003) Perinatal outcomes in two dissimilar immigrant populations in the United States: a dual epidemiologic paradox. Pediatrics 111(6):e676–e682
doi: 10.1542/peds.111.6.e676
pubmed: 12777585
Acevedo-Garcia D, Soobader M-J, Berkman LF (2005) The differential effect of foreign-born status on low birth weight by race/ethnicity and education. Pediatrics 115(1):e20–e30
doi: 10.1542/peds.2004-1306
pubmed: 15629963
Hessol NA, Fuentes-Afflick E (2000) The perinatal advantage of Mexican-origin Latina women. Ann Epidemiol 10(8):516–523
doi: 10.1016/S1047-2797(00)00073-9
pubmed: 11118931
Gagnon AJ et al (2009) Migration to western industrialised countries and perinatal health: a systematic review. Soc Sci Med 69(6):934–946
doi: 10.1016/j.socscimed.2009.06.027
pubmed: 19664869
Pottie K et al (2011) Evidence-based clinical guidelines for immigrants and refugees. CMAJ 183(12):E824–E925
doi: 10.1503/cmaj.090313
pubmed: 20530168
pmcid: 3168666
Fair F et al (2020) Migrant women’s experiences of pregnancy, childbirth and maternity care in European countries: a systematic review. PLoS ONE 15(2):e0228378
doi: 10.1371/journal.pone.0228378
pubmed: 32045416
pmcid: 7012401
David M, Pachaly J, Vetter K (2006) Perinatal outcome in Berlin (Germany) among immigrants from Turkey. Arch Gynecol Obstet 274(5):271–278
doi: 10.1007/s00404-006-0182-7
pubmed: 16847635
David M et al (2018) Obstetric care quality indicators and outcomes based on the degree of acculturation of immigrants-results from a cross-sectional study in Berlin. Arch Gynecol Obstet 297(2):313–322
doi: 10.1007/s00404-017-4574-7
pubmed: 29071577
Bozorgmehr K et al (2018) Differences in pregnancy outcomes and obstetric care between asylum seeking and resident women: a cross-sectional study in a German federal state, 2010–2016. BMC Pregnancy Childbirth 18(1):417
doi: 10.1186/s12884-018-2053-1
pubmed: 30355297
pmcid: 6201533
Allerstorfer C et al (2024) Influence of basic knowledge about female health, physiology, and contraception on unintended pregnancies: an international multicenter survey among women in Austria, Germany and Switzerland. Archives Gynecol Obstet. https://doi.org/10.1007/s00404-024-07441-1
doi: 10.1007/s00404-024-07441-1
Brzezinski ZJ, Szamotulska K (1994) The widening gap in low birthweight rates between extreme social groups in Poland during 1985–90. Paediatr Perinat Epidemiol 8(4):373–383
doi: 10.1111/j.1365-3016.1994.tb00476.x
pubmed: 7870622
Koupilova I et al (1998) Increasing social variation in birth outcomes in the czech republic after 1989. Am J Public Health 88(9):1343–1347
doi: 10.2105/AJPH.88.9.1343
pubmed: 9736874
pmcid: 1509095
Koupilova I et al (2000) Social determinants of birthweight and length of gestation in Estonia during the transition to democracy. Int J Epidemiol 29(1):118–124
doi: 10.1093/ije/29.1.118
pubmed: 10750613
Juárez S et al (2014) Maternal education and perinatal outcomes among Spanish women residing in southern Spain (2001–2011). Matern Child Health J 18:1814–1822
doi: 10.1007/s10995-013-1425-4
pubmed: 24374730
Mortensen LH et al (2010) Income-related and educational inequality in small-for-gestational age and preterm birth in Denmark and Finland 1987–2003. Scand Public Health 38(1):40–45
doi: 10.1177/1403494809353820
Novillo-Del-Alamo B et al (2024) Deprived areas and adverse perinatal outcome: a systematic review. Arch Gynecol Obstet 309(4):1205–1218
doi: 10.1007/s00404-023-07300-5
pubmed: 38063892
DESTATIS. Statistische Bundesamt: Pressemitteilung Nr. 261 vom 01.08.2017. 2017]; Available from: https://www.destatis.de/DE/PresseService/Presse/Pressemitteilungen/2017/08/PD17_261_12511.html . Accessed 16 Mar 2018
DESTATIS, Migration und Integration. https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Bevoelkerung/Migration-Integration/_inhalt.html , 2023. Accessed 16 Mar 2023.
Borgschulte HS et al (2018) Health care provision for refugees in Germany–one year evaluation of an outpatient clinic in an urban emergency accommodation. BMC Health Serv Res 18(1):488
doi: 10.1186/s12913-018-3174-y
pubmed: 29940931
pmcid: 6016127
D’Haenens F et al (2019) The effects of continuity of care on the health of mother and child in the postnatal period: a systematic review. Eur J Public Health 30(4):749–760
doi: 10.1093/eurpub/ckz082
Gagnon AJ et al (2014) Development of the migrant friendly maternity care questionnaire (MFMCQ) for migrants to Western societies: an international delphi consensus process. BMC Pregnancy Childbirth 14:200
doi: 10.1186/1471-2393-14-200
pubmed: 24916892
pmcid: 4088918
ROAM. Additional file 2–4: The MFMCQ in English, French and Spanish Version_17Apr2014. 2014]; Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4088918/ . Accessed on 5 Dec 2016
Gürbüz B et al (2019) The influence of migration on women’s satisfaction during pregnancy and birth: results of a comparative prospective study with the migrant friendly maternity care questionnaire (MFMCQ). Archives Gynecol Obstet 300:555–567
doi: 10.1007/s00404-019-05227-4
Seidel V et al (2024) Geburtsmedizinische versorgung bei gestationsdiabetes von geflüchteten und immigrierten frauen im vergleich zu nicht-immigrierten frauen in Berlin: eine analyse quantitativer daten der pregnancy and obstetric care for refugees (PROREF)-studie. Z Geburtshilfe Neonatol 228(3):260–269
doi: 10.1055/a-2238-3364
pubmed: 38373724
Barreto A et al (2024) Preterm birth risk and maternal nativity, ethnicity, and race. JAMA Netw Open 7(3):e243194–e243194
doi: 10.1001/jamanetworkopen.2024.3194
pubmed: 38512251
pmcid: 10958237
Bastola K et al (2020) Differences in caesarean delivery and neonatal outcomes among women of migrant origin in Finland: a population-based study. Paediatr Perinat Epidemiol 34(1):12–20
doi: 10.1111/ppe.12611
pubmed: 31960477
Li X, Sundquist J, Sundquist K (2013) Immigrants and preterm births: a nationwide epidemiological study in Sweden. Matern Child Health J 17:1052–1058
doi: 10.1007/s10995-012-1087-7
pubmed: 22833337
Ashley-Koch A, Yang Q, Olney RS (2000) Sickle hemoglobin (Hb S) allele and sickle cell disease: a huge review. Am J Epidemiol 151(9):839–845
doi: 10.1093/oxfordjournals.aje.a010288
pubmed: 10791557
Canatan D et al (2021) Immigration and screening programs for hemoglobinopathies in Italy, Spain and Turkey. Acta Biomed 92(4):e2021410
pubmed: 34487057
Oberaigner W, Leitner H, Oberaigner K (2013) Migrants and obstetrics in Austria–applying a new questionnaire shows differences in obstetric care and outcome. Wien Klin Wochenschr 125:34–40
doi: 10.1007/s00508-012-0312-0
pubmed: 23292644
Belihu FB, Small R, Davey M-A (2017) Episiotomy and severe perineal trauma among Eastern African immigrant women giving birth in public maternity care: a population based study in Victoria. Aust Women Birth 30(4):282–290
doi: 10.1016/j.wombi.2016.11.008
Rust G et al (2004) Racial and ethnic disparities in the provision of epidural analgesia to Georgia Medicaid beneficiaries during labor and delivery. Am J Obstet Gynecol 191(2):456–462
doi: 10.1016/j.ajog.2004.03.005
pubmed: 15343221
Yoong W et al (2004) Obstetric performance of ethnic Kosovo Albanian asylum seekers in London: a case-control study. J Obstet Gynaecol 24(5):510–512
doi: 10.1080/01443610410001722527
pubmed: 15369928
Seidel V et al (2022) Reasons for a lower rate of epidural anesthesia during birth for immigrant women in the eyes of medical staff: a mixed-methods analysis. J Immigr Minority Health 24:1501–1507
doi: 10.1007/s10903-022-01357-1
David M et al (2014) Comparison of perinatal data of immigrant women of turkish origin and german women-results of a prospective study in Berlin. Geburtshilfe Frauenheilkd 74(5):441–448
doi: 10.1055/s-0034-1368489
pubmed: 25089056
pmcid: 4078217
Gewalt SC et al (2018) Psychosocial health of asylum seeking women living in state-provided accommodation in Germany during pregnancy and early motherhood: a case study exploring the role of social determinants of health. PLoS ONE 13(12):e0208007
doi: 10.1371/journal.pone.0208007
pubmed: 30592728
pmcid: 6310271
Huang C-C, Li C-Y, Yang C-H (2012) Cultural implications of differing rates of medically indicated and elective cesarean deliveries for foreign-born versus native-born Taiwanese mothers. Matern Child Health J 16:1008–1014
doi: 10.1007/s10995-011-0824-7
pubmed: 21611716
David M et al (2015) Caesarean section frequency among immigrants, second- and third-generation women, and non-immigrants: prospective study in berlin/germany. PLoS ONE 10(5):e0127489
doi: 10.1371/journal.pone.0127489
pubmed: 25985437
pmcid: 4435809
Belihu FB, Small R, Davey MA (2017) Variations in first-time caesarean birth between Eastern African immigrants and Australian-born women in public care: a population-based investigation in Victoria. Aust N Z J Obstet Gynaecol 57(3):294–301
doi: 10.1111/ajo.12491
pubmed: 27338020