Association between language barrier and inadequate prenatal care utilization among migrant women

BACKGROUND: Language barriers may limit access to care and thus be associated with increased risk of adverse maternal and perinatal outcomes. Our objective is to assess the association between this language barrier and inadequate prenatal care utilization among migrant women. METHODS: The analysis took place in the French multicentre prospective PreCARE cohort, conducted in four university hospital maternity units in the northern Paris area, having a professional interpreting service. This cohort included 4803 migrant women registered and giving birth between 2010 and 2012. Migrants’ language barrier was categorized in three groups: no, partial or total. Inadequate prenatal care utilization was assessed according to the modified Adequacy of Prenatal Care Utilization Index through multivariable logistic regression models. RESULTS: Among the 4803 migrant women included, 16.3% had a partial and 3.8% a total language barrier. Migrants with language barrier had resided less time in France, experienced social deprivation and undocumented status more frequently than those with no language barrier. Compared to migrants with no language barrier, those with partial (RR 1.23, 95%CI 1.13-1.33) and total (RR 1.28, 95%CI 1.10-1.50) language barrier were at higher risk of inadequate PCU. Adjustment for maternal age, parity, and region of birth did not modify these association, which were noted particularly among socially deprived women. CONCLUSIONS: Migrant women with language barrier have a higher risk of inadequate prenatal care utilization than those without. These findings underscore the importance of targeted efforts to bring women with language barrier to prenatal care. KEY MESSAGES: • Compared with migrant women with no language barrier, those with such barrier, either total or partial, have a higher risk of inadequate prenatal care utilization. • These findings underscore the importance of targeted efforts to bring women with language barrier to prenatal care.