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Published in: BMC Pregnancy and Childbirth 1/2021

Open Access 01-12-2021 | Research

Maternal region of origin and Small for gestational age: a cross-sectional analysis of Victorian perinatal data

Authors: Sarah Grundy, Patricia Lee, Kirsten Small, Faruk Ahmed

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

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Abstract

Background

Being born small for gestational age is a strong predictor of the short- and long-term health of the neonate, child, and adult. Variation in the rates of small for gestational age have been identified across population groups in high income countries, including Australia. Understanding the factors contributing to this variation may assist clinicians to reduce the morbidity and mortality associated with being born small. Victoria, in addition to New South Wales, accounts for the largest proportion of net overseas migration and births in Australia. The aim of this research was to analyse how migration was associated with small for gestational age in Victoria.

Methods

This was a cross sectional population health study of singleton births in Victoria from 2009 to 2018 (n = 708,475). The prevalence of being born small for gestational age (SGA; <10th centile) was determined for maternal region of origin groups. Multivariate logistic regression analysis was used to analyse the association between maternal region of origin and SGA.

Results

Maternal region of origin was an independent risk factor for SGA in Victoria (p < .001), with a prevalence of SGA for migrant women of 11.3% (n = 27,815) and 7.3% for Australian born women (n = 33,749). Women from the Americas (aOR1.24, 95%CI:1.14 to 1.36), North Africa, North East Africa, and the Middle East (aOR1.57, 95%CI:1.52 to 1.63); Southern Central Asia (aOR2.58, 95%CI:2.50 to 2.66); South East Asia (aOR2.02, 95%CI: 1.95 to 2.01); and sub-Saharan Africa (aOR1.80, 95%CI:1.69 to 1.92) were more likely to birth an SGA child in comparison to women born in Australia.

Conclusions

Victorian woman’s region of origin was an independent risk factor for SGA. Variation in the rates of SGA between maternal regions of origin suggests additional factors such as a woman’s pre-migration exposures, the context of the migration journey, settlement conditions and social environment post migration might impact the potential for SGA. These findings highlight the importance of intergenerational improvements to the wellbeing of migrant women and their children. Further research to identify modifiable elements that contribute to birthweight differences across population groups would help enable appropriate healthcare responses aimed at reducing the rate of being SGA.
Literature
1.
go back to reference United Nations. Transforming our world: the 2030 agenda for sustainable development. New York: UN Publishing; 2015. United Nations. Transforming our world: the 2030 agenda for sustainable development. New York: UN Publishing; 2015.
4.
go back to reference Lee A, Kozuki N, Cousens S, Stevens G, Blencowe H, Silveira M, et al. Estimates of burden and consequences of infants born small for gestational age in low- and middle-income countries with INTERGROWTH-21 st standard: Analysis of CHERG datasets. Br Med J (Online). 2017;358:j3677.CrossRef Lee A, Kozuki N, Cousens S, Stevens G, Blencowe H, Silveira M, et al. Estimates of burden and consequences of infants born small for gestational age in low- and middle-income countries with INTERGROWTH-21 st standard: Analysis of CHERG datasets. Br Med J (Online). 2017;358:j3677.CrossRef
7.
go back to reference Australian Institute of Health and Welfare. Australia's Health 2018. Canberra: Australian Institute of Health and Welfare; 2018. Report No.: 16 Australian Institute of Health and Welfare. Australia's Health 2018. Canberra: Australian Institute of Health and Welfare; 2018. Report No.: 16
10.
go back to reference World Health Organization Global nutrition targets 2025: Low birth weight policy brief. Geneva: World Health Organization; 2014. World Health Organization Global nutrition targets 2025: Low birth weight policy brief. Geneva: World Health Organization; 2014.
12.
go back to reference Burton GJ, Redman CW, Roberts JM, Moffett A. Pre-eclampsia: pathophysiology and clinical implications. Br Med J. 2019;366:l2381.CrossRef Burton GJ, Redman CW, Roberts JM, Moffett A. Pre-eclampsia: pathophysiology and clinical implications. Br Med J. 2019;366:l2381.CrossRef
13.
go back to reference Denize KM, Acharya N, Prince SA, da Silva DF, Harvey ALJ, Ferraro ZM, et al. Addressing cultural, racial and ethnic discrepancies in guideline discordant gestational weight gain: a systematic review and meta-analysis. Peer J. 2018;2018(8):e5407.CrossRef Denize KM, Acharya N, Prince SA, da Silva DF, Harvey ALJ, Ferraro ZM, et al. Addressing cultural, racial and ethnic discrepancies in guideline discordant gestational weight gain: a systematic review and meta-analysis. Peer J. 2018;2018(8):e5407.CrossRef
14.
go back to reference Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW. Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: Systematic review and meta-analysis. Br Med J. 2013;346(6):f3443-f.CrossRef Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW. Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: Systematic review and meta-analysis. Br Med J. 2013;346(6):f3443-f.CrossRef
16.
19.
go back to reference Shapiro GD, Bushnik T, Wilkins R, Kramer MS, Kaufman JS, Sheppard AJ, et al. Adverse birth outcomes in relation to maternal marital and cohabitation status in Canada. Ann Epidemiol. 2018;28(8):503–9.e11.CrossRef Shapiro GD, Bushnik T, Wilkins R, Kramer MS, Kaufman JS, Sheppard AJ, et al. Adverse birth outcomes in relation to maternal marital and cohabitation status in Canada. Ann Epidemiol. 2018;28(8):503–9.e11.CrossRef
21.
go back to reference Ciobanu A, Rouvali A, Syngelaki A, Akolekar R, Nicolaides KH. Prediction of small for gestational age neonates: Screening by maternal factors, fetal biometry, and biomarkers at 35–37 weeks’ gestation. Am J Obstetr Gynecol. 2019;220(5):486.CrossRef Ciobanu A, Rouvali A, Syngelaki A, Akolekar R, Nicolaides KH. Prediction of small for gestational age neonates: Screening by maternal factors, fetal biometry, and biomarkers at 35–37 weeks’ gestation. Am J Obstetr Gynecol. 2019;220(5):486.CrossRef
22.
go back to reference Blackburn S. Maternal, fetal and neonatal physiology. 4th ed. United States of America: Elsevier Saunders; 2013. Blackburn S. Maternal, fetal and neonatal physiology. 4th ed. United States of America: Elsevier Saunders; 2013.
24.
go back to reference Pugh SJ, Albert PS, Kim S, Grobman W, Hinkle SN, Newman RB, et al. Patterns of gestational weight gain and birthweight outcomes in the Eunice Kennedy Shriver National Institute of Child Health and Human Development fetal growth studies–singletons: a prospective study. Am J Obstetr Gynecol. 2017;217(3):346.e1–e11.CrossRef Pugh SJ, Albert PS, Kim S, Grobman W, Hinkle SN, Newman RB, et al. Patterns of gestational weight gain and birthweight outcomes in the Eunice Kennedy Shriver National Institute of Child Health and Human Development fetal growth studies–singletons: a prospective study. Am J Obstetr Gynecol. 2017;217(3):346.e1–e11.CrossRef
25.
29.
go back to reference Getnet W, Aycheh W, Tessema T. Determinants of food taboos in the pregnant women of the Awabel District, East Gojjam zone, Amhara Regional State in Ethiopia. Adv in Public Health. 2018;2018:9198076.CrossRef Getnet W, Aycheh W, Tessema T. Determinants of food taboos in the pregnant women of the Awabel District, East Gojjam zone, Amhara Regional State in Ethiopia. Adv in Public Health. 2018;2018:9198076.CrossRef
30.
go back to reference Zerfu TA, Umeta M, Baye K. Dietary habits, food taboos, and perceptions towards weight gain during pregnancy in Arsi, rural central Ethiopia: A qualitative cross-sectional study. J Health Popul Nutr. 2016;35(1):22.CrossRef Zerfu TA, Umeta M, Baye K. Dietary habits, food taboos, and perceptions towards weight gain during pregnancy in Arsi, rural central Ethiopia: A qualitative cross-sectional study. J Health Popul Nutr. 2016;35(1):22.CrossRef
31.
go back to reference Bushnik T, Yang S, Kaufman JS, Kramer MS, Wilkins R. Socioeconomic disparities in small-for-gestational-age birth and preterm birth. Health Rep. 2017;28(11):3–10.PubMed Bushnik T, Yang S, Kaufman JS, Kramer MS, Wilkins R. Socioeconomic disparities in small-for-gestational-age birth and preterm birth. Health Rep. 2017;28(11):3–10.PubMed
32.
go back to reference Hirst JE, Knight HE, Ohuma EO, Dwyer T, Hennig BD, Papageorghiou AT, et al. Social gradient of birthweight in England assessed using the INTERGROWTH-21st gestational age-specific standard. Arch Dis Child Fetal Neonatal Ed. 2018;104(5):F486–F92.CrossRef Hirst JE, Knight HE, Ohuma EO, Dwyer T, Hennig BD, Papageorghiou AT, et al. Social gradient of birthweight in England assessed using the INTERGROWTH-21st gestational age-specific standard. Arch Dis Child Fetal Neonatal Ed. 2018;104(5):F486–F92.CrossRef
34.
go back to reference Kayode GA, Amoakoh-Coleman M, Akua Agyepong I, Ansah E, Grobbee DE, Klipstein-Grobusch K. Contextual risk factors for low birth weight: A multilevel analysis. Plos One. 2014;9(10):e109333-e.CrossRef Kayode GA, Amoakoh-Coleman M, Akua Agyepong I, Ansah E, Grobbee DE, Klipstein-Grobusch K. Contextual risk factors for low birth weight: A multilevel analysis. Plos One. 2014;9(10):e109333-e.CrossRef
39.
go back to reference Kothari CL, Paul R, Dormitorio B, Ospina F, James A, Lenz D, et al. The interplay of race, socioeconomic status and neighborhood residence upon birth outcomes in a high black infant mortality community. Soc Sci Med J Popul Health. 2016;2:859–67. Kothari CL, Paul R, Dormitorio B, Ospina F, James A, Lenz D, et al. The interplay of race, socioeconomic status and neighborhood residence upon birth outcomes in a high black infant mortality community. Soc Sci Med J Popul Health. 2016;2:859–67.
42.
go back to reference Heslehurst N, Brown H, Pemu A, Coleman H, Rankin J. Perinatal health outcomes and care among asylum seekers and refugees: a systematic review of systematic reviews. BioMed Central Med. 2018;16(1):89–25. Heslehurst N, Brown H, Pemu A, Coleman H, Rankin J. Perinatal health outcomes and care among asylum seekers and refugees: a systematic review of systematic reviews. BioMed Central Med. 2018;16(1):89–25.
46.
go back to reference Davies-Tuck ML, Davey M-A, Wallace EM. Maternal region of birth and stillbirth in Victoria, Australia 2000–2011: A retrospective cohort study of Victorian perinatal data. Plos One. 2017;12(6):e0178727-e.CrossRef Davies-Tuck ML, Davey M-A, Wallace EM. Maternal region of birth and stillbirth in Victoria, Australia 2000–2011: A retrospective cohort study of Victorian perinatal data. Plos One. 2017;12(6):e0178727-e.CrossRef
47.
go back to reference Belihu FB, Davey M-A, Small R. Perinatal health outcomes of East African immigrant populations in Victoria, Australia: A population based study. BioMed Central Pregnancy and Childbirth. 2016;16(1):86.CrossRef Belihu FB, Davey M-A, Small R. Perinatal health outcomes of East African immigrant populations in Victoria, Australia: A population based study. BioMed Central Pregnancy and Childbirth. 2016;16(1):86.CrossRef
54.
go back to reference Victorian Government. Victorian perinatal data collection manual, version 7.0. Melbourne: Department of Health and Human Services; 2019. Victorian Government. Victorian perinatal data collection manual, version 7.0. Melbourne: Department of Health and Human Services; 2019.
56.
go back to reference Australian Bureau of Statistics. Technical paper: socio-economic indexes for areas (SEIFA) 2016. ACT: Commonwealth of Australia; 2018. Australian Bureau of Statistics. Technical paper: socio-economic indexes for areas (SEIFA) 2016. ACT: Commonwealth of Australia; 2018.
58.
go back to reference Position statement: detection and management of fetal growth restriction in singleton pregnancies. Sydney: Centre of Research Excellence in Stillbirth. 2019. Position statement: detection and management of fetal growth restriction in singleton pregnancies. Sydney: Centre of Research Excellence in Stillbirth. 2019.
59.
go back to reference United Nations. International migration 2019: highlights. South Brisbane: Department of Economic and Social Affairs PD; 2019. United Nations. International migration 2019: highlights. South Brisbane: Department of Economic and Social Affairs PD; 2019.
62.
go back to reference Villalonga-Olives E, Kawachi I, von Steinbüchel N. Pregnancy and birth outcomes among immigrant women in the US and Europe: a systematic review. J Immigr Minor Health. 2016;19(6):1469–87.CrossRef Villalonga-Olives E, Kawachi I, von Steinbüchel N. Pregnancy and birth outcomes among immigrant women in the US and Europe: a systematic review. J Immigr Minor Health. 2016;19(6):1469–87.CrossRef
66.
go back to reference Eskild A, Sommerfelt S, Skau I, Grytten J. Offspring birthweight and placental weight in immigrant women from conflict-zone countries; does length of residence in the host country matter? A population study in Norway. Acta Obstet Gynecol Scand. 2019;99(5):615-22. https://doi.org/10.1111/aogs.13777. Eskild A, Sommerfelt S, Skau I, Grytten J. Offspring birthweight and placental weight in immigrant women from conflict-zone countries; does length of residence in the host country matter? A population study in Norway. Acta Obstet Gynecol Scand. 2019;99(5):615-22. https://​doi.​org/​10.​1111/​aogs.​13777.
72.
go back to reference Puthussery SMSW. 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 Pract Re. 2015;32:39–49.CrossRef Puthussery SMSW. 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 Pract Re. 2015;32:39–49.CrossRef
73.
go back to reference Yelland J, Riggs E, Wahidi S, Fouladi F, Casey S, Szwarc J, et al. How do Australian maternity and early childhood health services identify and respond to the settlement experience and social context of refugee background families? BioMed Central Pregnancy Childbirth. 2014;14(1):348.CrossRef Yelland J, Riggs E, Wahidi S, Fouladi F, Casey S, Szwarc J, et al. How do Australian maternity and early childhood health services identify and respond to the settlement experience and social context of refugee background families? BioMed Central Pregnancy Childbirth. 2014;14(1):348.CrossRef
78.
go back to reference Yelland J, Riggs E, Szwarc J, Casey S, Dawson W, Vanpraag D, et al. Bridging the Gap: Using an interrupted time series design to evaluate systems reform addressing refugee maternal and child health inequalities. Implement Sci. 2015;10(1):62.CrossRef Yelland J, Riggs E, Szwarc J, Casey S, Dawson W, Vanpraag D, et al. Bridging the Gap: Using an interrupted time series design to evaluate systems reform addressing refugee maternal and child health inequalities. Implement Sci. 2015;10(1):62.CrossRef
80.
go back to reference Henrichs J, Verfaille V, Jellema P, Viester L, Pajkrt E, Wilschut J, et al. Effectiveness of routine third trimester ultrasonography to reduce adverse perinatal outcomes in low risk pregnancy (the IRIS study): nationwide, pragmatic, multicentre, stepped wedge cluster randomised trial. Br Med J. 2019:l5517. https://doi.org/10.1136/bmj.l5517. Henrichs J, Verfaille V, Jellema P, Viester L, Pajkrt E, Wilschut J, et al. Effectiveness of routine third trimester ultrasonography to reduce adverse perinatal outcomes in low risk pregnancy (the IRIS study): nationwide, pragmatic, multicentre, stepped wedge cluster randomised trial. Br Med J. 2019:l5517. https://​doi.​org/​10.​1136/​bmj.​l5517.
Metadata
Title
Maternal region of origin and Small for gestational age: a cross-sectional analysis of Victorian perinatal data
Authors
Sarah Grundy
Patricia Lee
Kirsten Small
Faruk Ahmed
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-021-03864-9

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