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Severe maternal morbidity associated with maternal birthplace in three high-immigration settings

Background: Maternal mortality and morbidity vary substantially worldwide. It is unknown if these geographic differences translate into disparities in severe maternal morbidity among immigrants from various world regions. We assessed disparities in severe maternal morbidity between immigrant women f...

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Autores principales: Urquia, Marcelo L., Glazier, Richard H., Mortensen, Laust, Nybo-Andersen, Anne-Marie, Small, Rhonda, Davey, Mary-Ann, Rööst, Mattias, Essén, Birgitta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4512956/
https://www.ncbi.nlm.nih.gov/pubmed/25587005
http://dx.doi.org/10.1093/eurpub/cku230
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author Urquia, Marcelo L.
Glazier, Richard H.
Mortensen, Laust
Nybo-Andersen, Anne-Marie
Small, Rhonda
Davey, Mary-Ann
Rööst, Mattias
Essén, Birgitta
author_facet Urquia, Marcelo L.
Glazier, Richard H.
Mortensen, Laust
Nybo-Andersen, Anne-Marie
Small, Rhonda
Davey, Mary-Ann
Rööst, Mattias
Essén, Birgitta
author_sort Urquia, Marcelo L.
collection PubMed
description Background: Maternal mortality and morbidity vary substantially worldwide. It is unknown if these geographic differences translate into disparities in severe maternal morbidity among immigrants from various world regions. We assessed disparities in severe maternal morbidity between immigrant women from various world regions giving birth in three high-immigration countries. Methods: We used population-based delivery data from Victoria; Australia and Ontario, Canada and national data from Denmark, in the most recent 10-year period ending in 2010 available to each participating centre. Each centre provided aggregate data according to standardized definitions of the outcome, maternal regions of birth and covariates for pooled analyses. We used random effects and stratified logistic regression to obtain odds ratios (ORs) with 95% confidence intervals (95% CIs), adjusted for maternal age, parity and comparability scores. Results: We retrieved 2,322,907 deliveries in all three receiving countries, of which 479,986 (21%) were to immigrant women. Compared with non-immigrants, only Sub-Saharan African women were consistently at higher risk of severe maternal morbidity in all three receiving countries (pooled adjusted OR: 1.67; 95% CI: 1.43, 1.95). In contrast, both Western and Eastern European immigrants had lower odds (OR: 0.82; 95% CI: 0.70, 0.96 and OR: 0.64; 95% CI: 0.49, 0.83, respectively). The most common diagnosis was severe pre-eclampsia followed by uterine rupture, which was more common among Sub-Saharan Africans in all three settings. Conclusions: Immigrant women from Sub-Saharan Africa have higher rates of severe maternal morbidity. Other immigrant groups had similar or lower rates than the majority locally born populations.
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spelling pubmed-45129562015-07-27 Severe maternal morbidity associated with maternal birthplace in three high-immigration settings Urquia, Marcelo L. Glazier, Richard H. Mortensen, Laust Nybo-Andersen, Anne-Marie Small, Rhonda Davey, Mary-Ann Rööst, Mattias Essén, Birgitta Eur J Public Health Mother and Child Health Background: Maternal mortality and morbidity vary substantially worldwide. It is unknown if these geographic differences translate into disparities in severe maternal morbidity among immigrants from various world regions. We assessed disparities in severe maternal morbidity between immigrant women from various world regions giving birth in three high-immigration countries. Methods: We used population-based delivery data from Victoria; Australia and Ontario, Canada and national data from Denmark, in the most recent 10-year period ending in 2010 available to each participating centre. Each centre provided aggregate data according to standardized definitions of the outcome, maternal regions of birth and covariates for pooled analyses. We used random effects and stratified logistic regression to obtain odds ratios (ORs) with 95% confidence intervals (95% CIs), adjusted for maternal age, parity and comparability scores. Results: We retrieved 2,322,907 deliveries in all three receiving countries, of which 479,986 (21%) were to immigrant women. Compared with non-immigrants, only Sub-Saharan African women were consistently at higher risk of severe maternal morbidity in all three receiving countries (pooled adjusted OR: 1.67; 95% CI: 1.43, 1.95). In contrast, both Western and Eastern European immigrants had lower odds (OR: 0.82; 95% CI: 0.70, 0.96 and OR: 0.64; 95% CI: 0.49, 0.83, respectively). The most common diagnosis was severe pre-eclampsia followed by uterine rupture, which was more common among Sub-Saharan Africans in all three settings. Conclusions: Immigrant women from Sub-Saharan Africa have higher rates of severe maternal morbidity. Other immigrant groups had similar or lower rates than the majority locally born populations. Oxford University Press 2015-08 2015-01-13 /pmc/articles/PMC4512956/ /pubmed/25587005 http://dx.doi.org/10.1093/eurpub/cku230 Text en © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Mother and Child Health
Urquia, Marcelo L.
Glazier, Richard H.
Mortensen, Laust
Nybo-Andersen, Anne-Marie
Small, Rhonda
Davey, Mary-Ann
Rööst, Mattias
Essén, Birgitta
Severe maternal morbidity associated with maternal birthplace in three high-immigration settings
title Severe maternal morbidity associated with maternal birthplace in three high-immigration settings
title_full Severe maternal morbidity associated with maternal birthplace in three high-immigration settings
title_fullStr Severe maternal morbidity associated with maternal birthplace in three high-immigration settings
title_full_unstemmed Severe maternal morbidity associated with maternal birthplace in three high-immigration settings
title_short Severe maternal morbidity associated with maternal birthplace in three high-immigration settings
title_sort severe maternal morbidity associated with maternal birthplace in three high-immigration settings
topic Mother and Child Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4512956/
https://www.ncbi.nlm.nih.gov/pubmed/25587005
http://dx.doi.org/10.1093/eurpub/cku230
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