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 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

Perinatal health outcomes of East African immigrant populations in Victoria, Australia: a population based study

Authors: Fetene B. Belihu, Mary-Ann Davey, Rhonda Small

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

Login to get access

Abstract

Background

Sub-Saharan African women are often treated as a single group in epidemiological studies of immigrant birth outcomes, potentially masking variations across countries.

Methods

Cross-sectional population-based study of 432,567 singleton births in Victoria, Australia comparing mothers born in one of four East African countries (453 Eritreans, 1094 Ethiopians, 1,861 Somali and 1,404 Sudanese) relative to 427,755 Australian-born women was conducted using the Victorian Perinatal Data Collection. Pearson’s chi-square test and logistic regression analyses were performed to investigate disparities and estimate risks of perinatal mortality and other adverse perinatal outcomes after adjustment for confounders selected a priori.

Results

Compared with mothers born in Australia, East African immigrants as a group had elevated odds of perinatal mortality (ORadj1.83, 95 % CI 1.47, 2.28), small for gestational age births (SGA) (ORadj1.59 95 % CI 1.46, 1.74), very low birthweight (ORadj1.33, 95 % CI 1.11, 1.58) and very preterm birth (ORadj1.55, 95 % CI 1.27, 1.90). However, they had lower odds of preterm birth (ORadj0.86 95 % CI 0.76, 0.98) and macrosomia (ORadj0.65 95 % CI 0.51, 0.83). Individual country of birth analyses indicated significant variations, with Eritrean women having higher odds of very low birthweight (ORadj1.80, 95 % CI 1.09, 2.98), very preterm birth (ORadj 1.96, 95 % CI 1.08, 3.58), small for gestational age births (ORadj 1.52, 95 % CI 1.14, 2.03) and perinatal mortality (ORadj 2.69, 95 % CI 1.47, 4.91). Sudanese women had higher odds of low birthweight (ORadj 1.36, 95 % CI 1.10, 1.68), very low birthweight (ORadj 1.53, 95 % CI 1.13, 2.07), very preterm birth (ORadj 1.78, 95 % CI 1.26, 2.53), small for gestational age births (ORadj 2.13, 95 % CI 1.84, 2.47) and perinatal mortality (ORadj 2.10, 95 % CI 1.44, 3.07)]. Ethiopian women differed from Australian-born women only in relation to higher odds of very preterm birth, (ORadj1.70 95 % CI 1.16, 2.50), and only Somali-women had significantly lower odds of preterm birth (ORadj0.70 95 % CI 0.56, 0.88).

Conclusions

Overall, East African countries of birth were associated with increased perinatal death and some adverse perinatal outcomes; suggesting the need for strategies to enhance surveillance and health care delivery for these women. Analysis by individual country of birth groups has shown women from Eritrea and Sudan are particularly at increased risk of adverse outcomes, demonstrating the importance of antenatal identification of maternal country of birth.
Appendix
Available only for authorised users
Literature
1.
Casey BM, McIntire DD, Leveno KJ. The continuing value of the Apgar score for the assessment of newborn infants. N Engl J Med. 2001;344(7):467–71.CrossRefPubMed
2.
Lau C, Ambalavanan N, Chakraborty H, Wingate MS, Carlo WA. Extremely low birth weight and infant mortality rates in the United States. Pediatrics. 2013;131(5):855–60.CrossRefPubMed
3.
Meshari A, De Silva S, Rahman I. Fetal macrosomia—maternal risks and fetal outcome. Int J Gynaecol Obstet. 1990;32(3):215–22.CrossRefPubMed
4.
Curhan GC, Willett WC, Rimm EB, Spiegelman D, Ascherio AL, Stampfer MJ. Birth weight and adult hypertension, diabetes mellitus, and obesity in US men. Circulation. 1996;94(12):3246–50.CrossRefPubMed
5.
Helgertz J, Vågerö D. Small for gestational age and adulthood risk of disability pension: The contribution of childhood and adulthood conditions. Soc Sci Med. 2014;119:249–57.CrossRefPubMed
6.
Moster D, Lie RT, Markestad T. Long-term medical and social consequences of preterm birth. N Engl J Med. 2008;359(3):262–73.CrossRefPubMed
7.
Drysdale H, Ranasinha S, Kendall A, Knight M, Wallace EM. Ethnicity and the risk of late-pregnancy stillbirth. Med J Aust. 2012;197(5):278–81.CrossRefPubMed
8.
Small R, Gagnon A, Gissler M, Zeitlin J, Bennis M, Glazier R, et al. Somali women and their pregnancy outcomes postmigration: data from six receiving countries. BJOG. 2008;115(13):1630–40.CrossRefPubMedPubMedCentral
9.
Gagnon AJ, Zimbeck M, Zeitlin J, Collaboration R. Migration to western industrialised countries and perinatal health: a systematic review. Soc Sci Med. 2009;69(6):934–46.CrossRefPubMed
10.
Salim R, Mfra A, Garmi G, Shalev E. Comparison of intrapartum outcome among immigrant women from Ethiopia and the general obstetric population in Israel. Int J Gynaecol Obstet. 2012;118(2):161–5.CrossRefPubMed
11.
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.CrossRefPubMedPubMedCentral
12.
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):243–51.CrossRefPubMedPubMedCentral
13.
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.CrossRefPubMed
14.
Gibson-Helm M, Teede H, Block A, Knight M, East C, Wallace EM, et al. Maternal health and pregnancy outcomes among women of refugee background from African countries: a retrospective, observational study in Australia. BMC Pregnancy Childbirth. 2014;14(1):392.CrossRefPubMedPubMedCentral
15.
Gissler M, Alexander S, MacFarlane A, Small R, Stray‐Pedersen B, Zeitlin J, et al. Stillbirths and infant deaths among migrants in industrialized countries. Acta Obstet Gynecol Scand. 2009;88(2):134–48.CrossRefPubMed
16.
Pennell CE, Jacobsson B, Williams SM, Buus RM, Muglia LJ, Dolan SM, et al. Genetic epidemiologic studies of preterm birth: guidelines for research. Am J Obstet Gynecol. 2007;196(2):107–18.CrossRefPubMed
17.
Hessol NA, Fuentes-Afflick E. The perinatal advantage of Mexican-origin Latina women. Ann Epidemiol. 2000;10(8):516–23.CrossRefPubMed
18.
19.
Australian Bureau of Statistics. 2012 Year Book of Australia. Canberra: Australian Bureau of Statistics; 2012.
20.
Paxton GA, Rice J, Davie G, Carapetis JR, Skull SA. East African immigrant children in Australia have poor immunisation coverage. J Paediatr Child Health. 2011;47(12):888–92.CrossRefPubMed
21.
Hilder L, Zhichao Z, Parker M, Jahan S, Chambers G. Australia's mothers and babies 2012, Perinatal Statistics Series no. 30 cat.no. PER 69. Canberra: AIHW; 2014.
22.
Wasse H, Holt VL, Daling JR. Pregnancy risk factors and birth outcomes in Washington State: a comparison of Ethiopian-born and US-born women. Am J Public Health. 1994;84(9):1505–7.CrossRefPubMedPubMedCentral
23.
Calderon-Margalit R, Sherman D, Manor O, Kurzweil Y. Adverse Perinatal Outcomes among Immigrant Women from Ethiopia in Israel. Birth. 2015;42(2):125–31.CrossRefPubMed
24.
Johnson EB, Reed SD, Hitti J, Batra M. Increased risk of adverse pregnancy outcome among Somali immigrants in Washington state. Am J Obstet Gynecol. 2005;193(2):475–82.CrossRefPubMed
25.
Råssjö EB, Byrskog U, Samir R, Klingberg-Allvin M. Somali women’s use of maternity health services and the outcome of their pregnancies: a descriptive study comparing Somali immigrants with native-born Swedish women. Sex Reprod Healthc. 2013;4(3):99–106.CrossRefPubMed
26.
Essen B, Bodker B, Sjoberg NO, Langhoff-Roos J, Greisen G, Gudmundsson S, et al. Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services? BJOG. 2002;109(6):677–82.CrossRefPubMed
27.
28.
Davey MA, Sloan ML, Palma S, Riley M, King J. Methodological processes in validating and analysing the quality of population-based data: a case study using the Victorian Perinatal Data Collection. HIM J. 2013;42(3):12–9.PubMed
29.
Dobbins TA, Sullivan EA, Roberts CL, Simpson JM. Australian national birthweight percentiles by sex and gestational age, 1998-2007. Med J Aust. 2012;197(5):291–4.CrossRefPubMed
30.
Pink B. Information paper: an introduction to socio-economic indexes for areas (SEIFA), 2006. Canberra: Australian Bureau of Statistics (ABS); 2008.
31.
Puthussery S. Perinatal outcomes among migrant mothers in the United Kingdom: Is it a matter of biology, behaviour, policy, social determinants or access to health care? Best practice & research. Clinical Obstetrics & Gynaecology. 2015.
32.
Ekeus C, Cnattingius S, Essen B, Hjern A. Stillbirth among foreign-born women in Sweden. Eur J Public Health. 2011;21(6):788–92.CrossRefPubMed
33.
Urquia ML, Qiao Y, Ray JG, Liu C, Hjern A. Birth outcomes of foreign-born, native-born, and mixed couples in Sweden. Paediatric & Perinatal Epidemiology. 2015;29(2):123–30.CrossRef
34.
Dahlen HG, Schmied V, Dennis CL, Thornton C. Rates of obstetric intervention during birth and selected maternal and perinatal outcomes for low risk women born in Australia compared to those born overseas. BMC Pregnancy Childbirth. 2013;13:100.CrossRefPubMedPubMedCentral
35.
McMichael C, Manderson L. Somali women and well-being: Social networks and social capital among immigrant women in Australia. Hum Organ. 2004;63(1):88–99.CrossRef
36.
Abdelkerim AA, Grace M. Challenges to employment in newly emerging African communities in Australia: a review of the literature. Aust Soc Work. 2012;65(1):104–19.CrossRef
37.
Khashan AS, Everard C, McCowan LM, Dekker G, Moss-Morris R, Baker PN, et al. Second-trimester maternal distress increases the risk of small for gestational age. Psychol Med. 2014;44(13):2799–810.CrossRefPubMed
38.
Dejin-Karlsson E, Hanson BS, Ostergren PO, Lindgren A, Sjoberg NO, Marsal K. Association of a lack of psychosocial resources and the risk of giving birth to small for gestational age infants: a stress hypothesis. BJOG. 2000;107(1):89–100.CrossRefPubMed
39.
Zilko CEM, Rehkopf D, Abrams B. Association of maternal gestational weight gain with short-and long-term maternal and child health outcomes. Am J Obstet Gynecol. 2010;202(6):574. e1–e8.CrossRef
40.
41.
Hutcheon JA, Zhang X, Platt RW, Cnattingius S, Kramer MS. The case against customised birthweight standards. Paediatr Perinat Epidemiol. 2011;25(1):11–6.CrossRefPubMed
42.
Hillier SL, Nugent RP, Eschenbach DA, Krohn MA, Gibbs RS, Martin DH, et al. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. N Engl J Med. 1995;333(26):1737–42.CrossRefPubMed
43.
Lee AC, Katz J, Blencowe H, Cousens S, Kozuki N, Vogel JP, et al. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010. Lancet Global health. 2013;1(1):e26–36.CrossRefPubMed
44.
Richardus JH, Graafmans WC, Verloove-Vanhorick SP, Mackenbach JP. The perinatal mortality rate as an indicator of quality of care in international comparisons. Med Care. 1998;36(1):54–66.CrossRefPubMed
45.
Carolan M, Cassar L. Antenatal care perceptions of pregnant African women attending maternity services in Melbourne, Australia. Midwifery. 2010;26(2):189–201.CrossRefPubMed
46.
Correa-Velez I, Ryan J. Developing a best practice model of refugee maternity care. Women Birth. 2012;25(1):13–22.CrossRefPubMed
47.
Parker ED, Solberg LI, Foldes SS, Walker PF. A surveillance source of tobacco use differences among immigrant populations. Nicotine Tob Res. 2010;12(3):309–14.CrossRefPubMed
48.
Gibson-Helm ME, Teede HJ, Cheng IH, Block AA, Knight M, East CE, et al. Maternal health and pregnancy outcomes comparing migrant women born in humanitarian and nonhumanitarian source countries: a retrospective, observational study. Birth. 2015;42(2):116–24.CrossRefPubMed
49.
Gagnon AJ, Zimbeck M, Zeitlin J. Migration and perinatal health surveillance: an international Delphi survey. Eur J Obstet Gynecol Reprod Biol. 2010;149(1):37–43.CrossRefPubMed
Metadata
Title
Perinatal health outcomes of East African immigrant populations in Victoria, Australia: a population based study
Authors
Fetene B. Belihu
Mary-Ann Davey
Rhonda Small
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-0886-z

Other articles of this Issue 1/2016

BMC Pregnancy and Childbirth 1/2016 Go to the issue

Research article

Uterine salvage management for atonic postpartum hemorrhage using “modified lynch suture”

Research article

Self-reported pregnancy-related health problems and self-rated health status in Rwandan women postpartum: a population-based cross-sectional study

Research article

Birth preparedness, complication readiness and other determinants of place of delivery among mothers in Goba District, Bale Zone, South East Ethiopia

Research article

Health care professionals’ knowledge, attitudes and practices relating to umbilical cord blood banking and donation: an integrative review

Research article

The prevalence of disrespect and abuse during facility-based childbirth in urban Tanzania

Research article

Approach to the sonographic evaluation of fetal ventriculomegaly at 11 to 14 weeks gestation