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

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...

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Autores principales: Belihu, Fetene B., Davey, Mary-Ann, Small, Rhonda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845379/
https://www.ncbi.nlm.nih.gov/pubmed/27113930
http://dx.doi.org/10.1186/s12884-016-0886-z
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author Belihu, Fetene B.
Davey, Mary-Ann
Small, Rhonda
author_facet Belihu, Fetene B.
Davey, Mary-Ann
Small, Rhonda
author_sort Belihu, Fetene B.
collection PubMed
description 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 (OR(adj)1.83, 95 % CI 1.47, 2.28), small for gestational age births (SGA) (OR(adj)1.59 95 % CI 1.46, 1.74), very low birthweight (OR(adj)1.33, 95 % CI 1.11, 1.58) and very preterm birth (OR(adj)1.55, 95 % CI 1.27, 1.90). However, they had lower odds of preterm birth (OR(adj)0.86 95 % CI 0.76, 0.98) and macrosomia (OR(adj)0.65 95 % CI 0.51, 0.83). Individual country of birth analyses indicated significant variations, with Eritrean women having higher odds of very low birthweight (OR(adj)1.80, 95 % CI 1.09, 2.98), very preterm birth (OR(adj) 1.96, 95 % CI 1.08, 3.58), small for gestational age births (OR(adj) 1.52, 95 % CI 1.14, 2.03) and perinatal mortality (OR(adj) 2.69, 95 % CI 1.47, 4.91). Sudanese women had higher odds of low birthweight (OR(adj) 1.36, 95 % CI 1.10, 1.68), very low birthweight (OR(adj) 1.53, 95 % CI 1.13, 2.07), very preterm birth (OR(adj) 1.78, 95 % CI 1.26, 2.53), small for gestational age births (OR(adj) 2.13, 95 % CI 1.84, 2.47) and perinatal mortality (OR(adj) 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, (OR(adj)1.70 95 % CI 1.16, 2.50), and only Somali-women had significantly lower odds of preterm birth (OR(adj)0.70 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12884-016-0886-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-48453792016-04-27 Perinatal health outcomes of East African immigrant populations in Victoria, Australia: a population based study Belihu, Fetene B. Davey, Mary-Ann Small, Rhonda BMC Pregnancy Childbirth Research Article 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 (OR(adj)1.83, 95 % CI 1.47, 2.28), small for gestational age births (SGA) (OR(adj)1.59 95 % CI 1.46, 1.74), very low birthweight (OR(adj)1.33, 95 % CI 1.11, 1.58) and very preterm birth (OR(adj)1.55, 95 % CI 1.27, 1.90). However, they had lower odds of preterm birth (OR(adj)0.86 95 % CI 0.76, 0.98) and macrosomia (OR(adj)0.65 95 % CI 0.51, 0.83). Individual country of birth analyses indicated significant variations, with Eritrean women having higher odds of very low birthweight (OR(adj)1.80, 95 % CI 1.09, 2.98), very preterm birth (OR(adj) 1.96, 95 % CI 1.08, 3.58), small for gestational age births (OR(adj) 1.52, 95 % CI 1.14, 2.03) and perinatal mortality (OR(adj) 2.69, 95 % CI 1.47, 4.91). Sudanese women had higher odds of low birthweight (OR(adj) 1.36, 95 % CI 1.10, 1.68), very low birthweight (OR(adj) 1.53, 95 % CI 1.13, 2.07), very preterm birth (OR(adj) 1.78, 95 % CI 1.26, 2.53), small for gestational age births (OR(adj) 2.13, 95 % CI 1.84, 2.47) and perinatal mortality (OR(adj) 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, (OR(adj)1.70 95 % CI 1.16, 2.50), and only Somali-women had significantly lower odds of preterm birth (OR(adj)0.70 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12884-016-0886-z) contains supplementary material, which is available to authorized users. BioMed Central 2016-04-26 /pmc/articles/PMC4845379/ /pubmed/27113930 http://dx.doi.org/10.1186/s12884-016-0886-z Text en © Belihu et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Belihu, Fetene B.
Davey, Mary-Ann
Small, Rhonda
Perinatal health outcomes of East African immigrant populations in Victoria, Australia: a population based study
title Perinatal health outcomes of East African immigrant populations in Victoria, Australia: a population based study
title_full Perinatal health outcomes of East African immigrant populations in Victoria, Australia: a population based study
title_fullStr Perinatal health outcomes of East African immigrant populations in Victoria, Australia: a population based study
title_full_unstemmed Perinatal health outcomes of East African immigrant populations in Victoria, Australia: a population based study
title_short Perinatal health outcomes of East African immigrant populations in Victoria, Australia: a population based study
title_sort perinatal health outcomes of east african immigrant populations in victoria, australia: a population based study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845379/
https://www.ncbi.nlm.nih.gov/pubmed/27113930
http://dx.doi.org/10.1186/s12884-016-0886-z
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