Cecilia Ekéus1, Sven Cnattingius, Birgitta Essén, Anders Hjern. 1. Department of Women's and Children's Health, Division of Reproductive and Perinatal Health, Karolinska Institutet, Stockholm, Sweden. cecilia.ekeus@ki.se
Abstract
BACKGROUND: The aims of this study were: (i) to investigate stillbirth risk in offspring to foreign-born women by region of birth; (ii) if disparities in risks can be explained by socio-economic factors, pregnancy complications or maternal morbidity; and (iii) if the risk varies by time since immigration. METHODS: This was a population-based register study with data from the Swedish Medical Birth Register and socio-economic variables from national income and population registers. We studied single births from 1992 to 2005, and included 219,832 births to foreign-born women and 1,094,146 births to Swedish-born women. Logistic regression analysis was used to calculate odds ratios (ORs), using 95% confidence intervals (CIs). RESULTS: In all, 4104 antepartal and 255 intrapartal stillbirths occurred. Compared with births to Swedish women, the OR of stillbirth was 2.27 (95% CI 1.84-2.80) for births to women from Africa and 1.41 (95% CI 1.22-1.64) for births to women from Middle East, after adjustment for confounding factors. The risk of stillbirth was higher in immigrants who had been in Sweden for a short time period (<5 years) compared with those who had been in Sweden for a longer period, OR 1.21 (95% CI 1.05-1.40). CONCLUSIONS: The risk of stillbirth in immigrant women varies by region of birth and time since immigration, being highest in women from Africa and the Middle East, and the recently settled. Further studies are needed to identify the mechanisms behind these patterns.
BACKGROUND: The aims of this study were: (i) to investigate stillbirth risk in offspring to foreign-born women by region of birth; (ii) if disparities in risks can be explained by socio-economic factors, pregnancy complications or maternal morbidity; and (iii) if the risk varies by time since immigration. METHODS: This was a population-based register study with data from the Swedish Medical Birth Register and socio-economic variables from national income and population registers. We studied single births from 1992 to 2005, and included 219,832 births to foreign-born women and 1,094,146 births to Swedish-born women. Logistic regression analysis was used to calculate odds ratios (ORs), using 95% confidence intervals (CIs). RESULTS: In all, 4104 antepartal and 255 intrapartal stillbirths occurred. Compared with births to Swedish women, the OR of stillbirth was 2.27 (95% CI 1.84-2.80) for births to women from Africa and 1.41 (95% CI 1.22-1.64) for births to women from Middle East, after adjustment for confounding factors. The risk of stillbirth was higher in immigrants who had been in Sweden for a short time period (<5 years) compared with those who had been in Sweden for a longer period, OR 1.21 (95% CI 1.05-1.40). CONCLUSIONS: The risk of stillbirth in immigrant women varies by region of birth and time since immigration, being highest in women from Africa and the Middle East, and the recently settled. Further studies are needed to identify the mechanisms behind these patterns.
Authors: Helen D Bailey; Akilew A Adane; Brad M Farrant; Scott W White; Pia Hardelid; Carrington C J Shepherd Journal: Arch Gynecol Obstet Date: 2020-04-21 Impact factor: 2.344