Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2022

Open Access 01-12-2022 | Mood Disorders | Research

Psychosocial and behavioral health indicators among immigrant and non-immigrant recent mothers

Authors: Roheema Ewesesan, Mariette J. Chartier, Nathan C. Nickel, Elizabeth Wall-Wieler, Marcelo L. Urquia

Published in: BMC Pregnancy and Childbirth | Issue 1/2022

Login to get access

Abstract

Background

Perinatal risk factors can vary by immigration status. We examined psychosocial and behavioral perinatal health indicators according to immigration status and immigrant characteristics.

Methods

We conducted a population-based cross-sectional study of 33,754 immigrant and 172,342 non-immigrant childbearing women residents in Manitoba, Canada, aged 15–55 years, who had a live birth and available data from the universal newborn screen completed within 2 weeks postpartum, between January 2000 and December 2017. Immigration characteristics were from the Canadian federal government immigration database. Logistic regressions models were used to obtain Odds Ratios (OR) with 95% confidence intervals (CI) for the associations between immigration characteristics and perinatal health indicators, such as social isolation, relationship distress, partner violence, depression, alcohol, smoking, substance use, and late initiation of prenatal care.

Results

More immigrant women reported being socially isolated (12.3%) than non-immigrants (3.0%) (Adjusted Odds Ratio (aOR): 6.95, 95% CI: 6.57 to 7.36) but exhibited lower odds of depression, relationship distress, partner violence, smoking, alcohol, substance use, and late initiation of prenatal care. In analyses restricted to immigrants, recent immigrants (< 5 years) had higher odds of being socially isolated (aOR: 9.04, 95% CI: 7.48 to 10.94) and late initiation of prenatal care (aOR: 1.50, 95% CI: 1.07 to 2.12) compared to long-term immigrants (10 years or more) but lower odds of relationship distress, depression, alcohol, smoking and substance use. Refugee status was positively associated with relationship distress, depression, and late initiation of prenatal care. Secondary immigrants, whose last country of permanent residence differed from their country of birth, had lower odds of social isolation, relationship distress, and smoking than primary migrants. There were also differences by maternal region of birth.

Conclusion

Immigrant childbearing women had a higher prevalence of social isolation but a lower prevalence of other psychosocial and behavioral perinatal health indicators than non-immigrants. Health care providers may consider the observed heterogeneity in risk to tailor care approaches for immigrant subgroups at higher risk, such as refugees, recent immigrants, and those from certain world regions.
Literature
1.
Gagnon AJ, Dougherty G, Wahoush O, Saucier J-F, Dennis C-L, Stanger E, et al. International migration to Canada: the post-birth health of mothers and infants by immigration class. Soc Sci Med. 2013;76:197–207.PubMedCrossRef
2.
Urquia ML, Glazier RH, Blondel B, Zeitlin J, Gissler M, Macfarlane A, et al. International migration and adverse birth outcomes: role of ethnicity, region of origin and destination. J Epidemiol Community Health. 2010;64(3):243.PubMedCrossRef
3.
Kaushal N, Lu Y. Recent immigration to Canada and the United States: a mixed tale of relative selection. Int Migr Rev. 2015;49(2):479–522.PubMedCrossRef
4.
Kim I-H, Carrasco C, Muntaner C, McKenzie K, Noh S. Ethnicity and postmigration health trajectory in new immigrants to Canada. Am J Public Health. 2013;103(4):e96–e104.PubMedPubMedCentralCrossRef
5.
6.
7.
Wanigaratne S, Cole DC, Bassil K, Hyman I, Moineddin R, Urquia ML. The influence of refugee status and secondary migration on preterm birth. J Epidemiol Community Health. 2016;70(6):622–8.PubMedCrossRef
8.
Hyman I, Forte T, Du Mont J, Romans S, Cohen MM. The association between length of stay in Canada and intimate partner violence among immigrant women. Am J Public Health. 2006;96(4):654–9.PubMedPubMedCentralCrossRef
9.
Ahmad F, Ali M, Stewart D. Spousal-abuse among Canadian immigrant women. J Immigr Health. 2005;7:239–46.PubMedCrossRef
10.
Beydoun HA, Al-Sahab B, Beydoun MA, Tamim H. Intimate partner violence as a risk factor for postpartum depression among Canadian women in the maternity experience survey. Ann Epidemiol. 2010;20(8):575–83.PubMedPubMedCentralCrossRef
11.
Miszkurka M, Zunzunegui MV, Goulet L. Immigrant status, antenatal depressive symptoms, and frequency and source of violence: what's the relationship? Arch Women’s Mental Health. 2012;15(5):387–96.CrossRef
12.
Hwang S-S, Xi J, Cao Y, Feng X, Qiao X. Anticipation of migration and psychological stress and the three gorges dam project, China. Soc Sci Med. 2007;65(5):1012–24.PubMedPubMedCentralCrossRef
13.
Higginbottom GMA, Morgan M, Alexandre M, Chiu Y, Forgeron J, Kocay D, et al. Immigrant women’s experiences of maternity-care services in Canada: a systematic review using a narrative synthesis. Syst Rev. 2015;4(1):13.PubMedPubMedCentralCrossRef
14.
Garcia ER, Yim IS. A systematic review of concepts related to women's empowerment in the perinatal period and their associations with perinatal depressive symptoms and premature birth. BMC Pregnancy Childbirth. 2017;17(Suppl 2):347.PubMedPubMedCentralCrossRef
15.
Khawaja NG, Milner K. Acculturation stress in south Sudanese refugees: impact on marital relationships. Int J Intercult Relat. 2012;36(5):624–36.CrossRef
16.
Hyman I, Guruge S, Mason R. The impact of migration on marital relationships: a study of Ethiopian immigrants in Toronto. J Comp Fam Stud. 2008;39(2):149–63.CrossRef
17.
Hyman I, Mason R, Guruge S, Berman H, Kanagaratnam P, Manuel L. Perceptions of factors contributing to intimate partner violence among Sri Lankan Tamil immigrant women in Canada. Health Care Women Int. 2011;32:779–94.PubMedCrossRef
18.
Dennis CL, Merry L, Gagnon AJ. Postpartum depression risk factors among recent refugee, asylum-seeking, non-refugee immigrant, and Canadian-born women: results from a prospective cohort study. Soc Psychiatry Psychiatr Epidemiol. 2017;52(4):411–22.PubMedCrossRef
19.
Daoud N, O’Brien K, O’Campo P, Harney S, Harney E, Bebee K, et al. Postpartum depression prevalence and risk factors among indigenous, non-indigenous and immigrant women in Canada. Can J Public Health. 2019;110(4):440–52.PubMedPubMedCentralCrossRef
20.
Melchior M, Chollet A, Glangeaud-Freudenthal N, Saurel-Cubizolles M-J, Dufourg M-N, van der Waerden J, et al. Tobacco and alcohol use in pregnancy in France: the role of migrant status: the nationally representative ELFE study. Addict Behav. 2015;51:65–71.PubMedCrossRef
21.
Fanslow J, Silva M, Robinson E, Whitehead A. Violence during pregnancy: associations with pregnancy intendedness, pregnancy-related care, and alcohol and tobacco use among a representative sample of New Zealand women. Aust N Z J Obstet Gynaecol. 2008;48(4):398–404.PubMedCrossRef
22.
Gilbert NL, Nelson CR, Greaves L. Smoking cessation during pregnancy and relapse after childbirth in Canada. J Obstet Gynaecol Can. 2015;37(1):32–9.PubMedCrossRef
23.
Al-Sahab B, Saqib M, Hauser G, Tamim H. Prevalence of smoking during pregnancy and associated risk factors among Canadian women: a national survey. BMC Pregnancy Childbirth. 2010;10(1):24.PubMedPubMedCentralCrossRef
24.
Urquia ML, Frank JW, Glazier RH. From places to flows. International secondary migration and birth outcomes. Soc Sci Med. 2010;71(9):1620–6.PubMedCrossRef
25.
Greenwood MJ, Young PA. Geographically indirect immigration to Canada: description and analysis. Int Migr Rev. 1997;31(1):51–71.PubMedCrossRef
26.
27.
Fuller-Thomson E, Noack AM, George U. Health decline among recent immigrants to Canada: findings from a nationally-representative longitudinal survey. Can J Public Health. 2011;102(4):273–80.PubMedPubMedCentralCrossRef
28.
Urquia ML, Frank JW, Moineddin R, Glazier RH. Immigrants’ duration of residence and adverse birth outcomes: a population-based study. BJOG. 2010;117(5):591–601.PubMedPubMedCentralCrossRef
29.
Urquia ML, O'Campo PJ, Heaman MI. Revisiting the immigrant paradox in reproductive health: the roles of duration of residence and ethnicity. Soc Sci Med. 2012;74(10):1610–21.PubMedCrossRef
30.
Miszkurka M, Goulet L, Zunzunegui MV. Contributions of immigration to depressive symptoms among pregnant women in Canada. Can J Public Health. 2010;101(5):358–64.PubMedPubMedCentralCrossRef
31.
Robinson AM, Benzies KM, Cairns SL, Fung T, Tough SC. Who is distressed? A comparison of psychosocial stress in pregnancy across seven ethnicities. BMC Pregnancy Childbirth. 2016;16(1):215.PubMedPubMedCentralCrossRef
32.
Stewart DE, Gagnon A, Saucier J-F, Wahoush O, Dougherty G. Postpartum depression symptoms in newcomers. Can J Psychiatry. 2008;53(2):121–4.PubMedCrossRef
33.
Hyman I, Dussault G. Negative consequences of acculturation on health behaviour, social support and stress among pregnant southeast Asian immigrant women in Montreal: an exploratory study. Can J Public Health. 2000;91(5):357–60.PubMedPubMedCentralCrossRef
34.
Kingston D, Heaman M, Chalmers B, Kaczorowski J, O’Brien B, Lee L, et al. Comparison of maternity experiences of Canadian-born and recent and non-recent immigrant women: findings from the Canadian maternity experiences survey. J Obstet Gynaecol Can. 2011;33(11):1105–15.PubMedCrossRef
35.
Elo IT, Culhane JF. Variations in health and health behaviors by nativity among pregnant black women in Philadelphia. Am J Public Health. 2010;100(11):2185–92.PubMedPubMedCentralCrossRef
36.
37.
Brownell MD, Chartier M, Santos R, Au W, Roos NP, Girard D. Evaluation of a newborn screen for predicting out-of-home placement. Child Maltreat. 2011;16(4):239–49.PubMedCrossRef
38.
Urquia M, Walld R, Wanigaratne S, Eze N, Azimaee M, McDonald JT, et al. Linking National Immigration Data to provincial repositories: the case of Canada. International journal of population data. Science. 2021;6(1):1412.
39.
40.
Hughes RA, Heron J, Sterne JAC, Tilling K. Accounting for missing data in statistical analyses: multiple imputation is not always the answer. Int J Epidemiol. 2019;48(4):1294–304.PubMedPubMedCentralCrossRef
41.
Wirth KE, Tchetgen Tchetgen EJ, Murray M. Adjustment for missing data in complex surveys using doubly robust estimation: application to commercial sexual contact among Indian men. Epidemiology. 2010;21(6):863–71.PubMedPubMedCentralCrossRef
42.
Schreiber-Gregory D, Bader K. Logistic and linear regression assumptions: Violation recognition and control; 2018.
43.
Shoukri MM. Analysis of correlated data with SAS and R, fourth edition. Boca Raton: CRC Press, Taylor & Francis Group; 2018.CrossRef
44.
Montazer S. Disentangling the effects of primary and secondary international migration on psychological distress: the role of mastery. Can J Public Health. 2018;109(3):284–93.PubMedPubMedCentralCrossRef
45.
Snow G, Melvin GA, Boyle JA, Gibson-Helm M, East CE, McBride J, et al. Perinatal psychosocial assessment of women of refugee background. Women Birth. 2021;34(3):e302–e308.
46.
Urquia ML, Glazier RH, Mortensen L, Nybo-Andersen A-M, Small R, Davey M-A, et al. ROAM ft: severe maternal morbidity associated with maternal birthplace in three high-immigration settings. Eur J Pub Health. 2015;25(4):620–5.CrossRef
47.
Midlarsky E, Venkataramani-Kothari A, Plante M. Domestic violence in the Chinese and south Asian immigrant communities. Ann N Y Acad Sci. 2006;1087(1):279–300.PubMedCrossRef
48.
Röhr S, Wittmann F, Engel C, Enzenbach C, Witte AV, Villringer A, et al. Social factors and the prevalence of social isolation in a population-based adult cohort. Soc Psychiatry Psychiatr Epidemiol. 2021:1–10.
49.
Hurtado-de-Mendoza A, Gonzales FA, Serrano A, Kaltman S. Social isolation and perceived barriers to establishing social networks among Latina immigrants. Am J Community Psychol. 2014;53(1):73–82.PubMedCrossRef
50.
51.
Hawthorne G. Perceived social isolation in a community sample: its prevalence and correlates with aspects of peoples’ lives. Soc Psychiatry Psychiatr Epidemiol. 2008;43(2):140–50.PubMedCrossRef
52.
Schumaker JF, Shea JD, Monfries MM, Groth-Marnat G. Loneliness and life satisfaction in Japan and Australia. J Psychol. 1993;127(1):65–71.PubMedCrossRef
53.
Cacioppo J, Hawkley L. Social isolation and health, with an emphasis on underlying mechanisms. Perspect Biol Med. 2003;46:S39–52.PubMedCrossRef
54.
Milner K, Khawaja NG. Sudanese refugees in Australia: the impact of acculturation stress. J Pac Rim Psychol. 2010;4(1):19–29.CrossRef
55.
Stewart M, Dennis CL, Kariwo M, Kushner KE, Letourneau N, Makumbe K, et al. Challenges faced by refugee new parents from Africa in Canada. J Immigr Minor Health. 2015;17(4):1146–56.PubMedCrossRef
56.
Brown-Bowers A, McShane K, Wilson-Mitchell K, Gurevich M. Postpartum depression in refugee and asylum-seeking women in Canada: a critical health psychology perspective. Health (London). 2015;19(3):318–35.CrossRef
57.
O'Mahony JM, Donnelly TT. How does gender influence immigrant and refugee women's postpartum depression help-seeking experiences? J Psychiatr Ment Health Nurs. 2013;20(8):714–25.PubMedCrossRef
58.
Menjívar C, Salcido O. Immigrant women and domestic violence: common experiences in different countries. Gend Soc. 2002;16(6):898–920.CrossRef
59.
60.
Daoud N, Urquia ML, O'Campo P, Heaman M, Janssen PA, Smylie J, et al. Prevalence of abuse and violence before, during, and after pregnancy in a national sample of Canadian women. Am J Public Health. 2012;102(10):1893–901.PubMedPubMedCentralCrossRef
61.
Kingston D, Heaman M, Urquia M, O’Campo P, Janssen P, Thiessen K, et al. Correlates of abuse around the time of pregnancy: results from a national survey of Canadian women. Matern Child Health J. 2016;20(4):778–89.PubMedCrossRef
62.
Holtmann C, Rickards T. Domestic/intimate partner violence in the lives of immigrant women: a New Brunswick response. Can J Public Health. 2018;109(3):294–302.PubMedPubMedCentralCrossRef
63.
Stewart DE, Gagnon AJ, Merry LA, Dennis C-L. Risk factors and health profiles of recent migrant women who experienced violence associated with pregnancy. J Women's Health. 2012;21(10):1100–6.CrossRef
64.
World Health Organization. WHO multi-country study on women’s health and domestic violence against women summary report- initial results on prevalence, health outcomes and women’s responses, vol. 28; 2005.
65.
Chow A, Dharma C, Chen E, Mandhane PJ, Turvey SE, Elliott SJ, et al. Trajectories of depressive symptoms and perceived stress from pregnancy to the postnatal period among Canadian women: impact of employment and immigration. Am J Public Health. 2019;109(S3):S197–204.PubMedPubMedCentralCrossRef
66.
Ryan-Ibarra S, Epstein JF, Induni M, Wright MA. Current depression among women in California according to residence in the California-Mexico border region. Rev Panam Salud Publica. 2012;31(5):417–26.PubMedCrossRef
67.
Levecque K, Van Rossem R. Depression in Europe: does migrant integration have mental health payoffs? A cross-national comparison of 20 European countries. Ethn Health. 2015;20(1):49–65.PubMedCrossRef
68.
Lacey KK, Park J, Briggs AQ, Jackson JS. National origins, social context, timing of migration and the physical and mental health of Caribbeans living in and outside of Canada. Ethn Health. 2019;27(1):223–46.PubMedCrossRef
69.
King L, Feeley N, Gold I, Hayton B, Zelkowitz P. The healthy migrant effect and predictors of perinatal depression. Women Birth. 2019;32(3):e341–50.PubMedCrossRef
70.
O'Mahony J, Donnelly T. Immigrant and refugee women's post-partum depression help-seeking experiences and access to care: a review and analysis of the literature. J Psychiatr Ment Health Nurs. 2010;17(10):917–28.PubMedCrossRef
71.
Urquia ML, Frank JW, Moineddin R, Glazier RH. Does time since immigration modify neighborhood deprivation gradients in preterm birth? A multilevel analysis. J Urban Health. 2011;88(5):959–76.PubMedPubMedCentralCrossRef
72.
73.
Urquia M, Juárez S, Wall-Wieler E, Hjern A. Smoking during pregnancy among immigrant women with same-origin and Swedish-born partners. Nicotine Tob Res. 2020;23:349–56.PubMedCentralCrossRef
74.
Gonthier C, Estellat C, Deneux-Tharaux C, Blondel B, Alfaiate T, Schmitz T, et al. Association between maternal social deprivation and prenatal care utilization: the PreCARE cohort study. BMC Pregnancy Childbirth. 2017;17(1):126.PubMedPubMedCentralCrossRef
75.
Cresswell JA, Yu G, Hatherall B, Morris J, Jamal F, Harden A, et al. Predictors of the timing of initiation of antenatal care in an ethnically diverse urban cohort in the UK. BMC Pregnancy Childbirth. 2013;13(1):103.PubMedPubMedCentralCrossRef
76.
77.
Choté AA, Koopmans GT, Redekop WK, de Groot CJ, Hoefman RJ, Jaddoe VW, et al. Explaining ethnic differences in late antenatal care entry by predisposing, enabling and need factors in the Netherlands. The generation R study. Matern Child Health J. 2011;15(6):689–99.PubMedCrossRef
78.
Kandasamy T, Cherniak R, Shah R, Yudin MH, Spitzer R. Obstetric risks and outcomes of refugee women at a single Centre in Toronto. J Obstet Gynaecol Can. 2014;36(4):296–302.PubMedCrossRef
79.
Heaman MI, Green CG, Newburn-Cook CV, Elliott LJ, Helewa ME. Social inequalities in use of prenatal care in Manitoba. J Obstet Gynaecol Can. 2007;29(10):806–16.PubMedCrossRef
80.
81.
Metadata
Title
Psychosocial and behavioral health indicators among immigrant and non-immigrant recent mothers
Authors
Roheema Ewesesan
Mariette J. Chartier
Nathan C. Nickel
Elizabeth Wall-Wieler
Marcelo L. Urquia
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2022
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-022-04937-z

Other articles of this Issue 1/2022

BMC Pregnancy and Childbirth 1/2022 Go to the issue

Research

Age-modified factors associated with placental malaria in rural Burkina Faso

Research article

A new modified obstetric early warning score for prognostication of severe maternal morbidity

Correction

Correction: Antenatal cervical length measurement as a predictor of successful vaginal birth

Research

Prenatal sonographic findings in confirmed cases of Wolf-Hirschhorn syndrome

Case report

Axillary vein thrombosis 30 h after caesarean section: a case report and literature review

Research

Association of antimüllerian hormone with polycystic ovarian syndrome phenotypes and pregnancy outcomes of in vitro fertilization cycles with fresh embryo transfer