Matthias David1, Theda Borde2, Silke Brenne3, Babett Ramsauer4, Wolfgang Henrich5,6, Jürgen Breckenkamp7, Oliver Razum7. 1. Department of Gynecology, Charité University Medicine Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany. matthias.david@charite.de. 2. Alice Salomon University of Applied Sciences, Berlin, Germany. 3. Department of Gynecology, Charité University Medicine Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany. 4. Department of Obstetrics, Vivantes Klinikum Neukölln, Berlin, Germany. 5. Department of Obstetrics, Charité University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany. 6. Department of Obstetrics, Charité University Medicine Berlin, Campus Charité Mitte, Berlin, Germany. 7. Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany.
Abstract
BACKGROUND: In Germany, regular immigrants and their descendants have legal and financial access to health care equal to the general citizenry. Nonetheless, some of their health outcomes are comparatively unfavorable, and that is only partially explained by their lower socioeconomic status (SES). The aim of this study was to assess whether this disparity exists also for obstetric and perinatal outcomes. METHODS: We compared obstetric and perinatal outcomes between immigrant women (first or second generation) and non-immigrant women, delivering at three maternity hospitals in Berlin, Germany, 2011-2012. Multivariable logistic regression analysis was used to assess immigrant status and other possible risk factors for the baby being delivered preterm, small for gestational age (SGA), or transferred to neonatal care. RESULTS: The final database retained 6702 women, of whom 53.1% were first- or second-generation immigrants. First-generation Turkish immigrant women had significantly lower odds of preterm birth (OR 0.37, P < 0.001), SGA (OR 0.60, P = 0.0079), and transfer of the newborn to neonatal care (OR 0.61, P = 0.0034). Second-generation immigrant women had significantly lower odds of preterm birth (OR 0.67, P = 0.0049) or transfer of the newborn to neonatal care (OR 0.76, P = 0.0312). Moreover, women with education below university level, age 35+, or smokers had higher odds for poor outcomes. CONCLUSIONS: This study provides strong evidence that health disparities for obstetric and perinatal health outcomes do not exist in immigrants relative to native Germans, but exist instead in women without post-secondary-level education compared to women with such education, regardless of ethnicity or migration history.
BACKGROUND: In Germany, regular immigrants and their descendants have legal and financial access to health care equal to the general citizenry. Nonetheless, some of their health outcomes are comparatively unfavorable, and that is only partially explained by their lower socioeconomic status (SES). The aim of this study was to assess whether this disparity exists also for obstetric and perinatal outcomes. METHODS: We compared obstetric and perinatal outcomes between immigrant women (first or second generation) and non-immigrant women, delivering at three maternity hospitals in Berlin, Germany, 2011-2012. Multivariable logistic regression analysis was used to assess immigrant status and other possible risk factors for the baby being delivered preterm, small for gestational age (SGA), or transferred to neonatal care. RESULTS: The final database retained 6702 women, of whom 53.1% were first- or second-generation immigrants. First-generation Turkish immigrant women had significantly lower odds of preterm birth (OR 0.37, P < 0.001), SGA (OR 0.60, P = 0.0079), and transfer of the newborn to neonatal care (OR 0.61, P = 0.0034). Second-generation immigrant women had significantly lower odds of preterm birth (OR 0.67, P = 0.0049) or transfer of the newborn to neonatal care (OR 0.76, P = 0.0312). Moreover, women with education below university level, age 35+, or smokers had higher odds for poor outcomes. CONCLUSIONS: This study provides strong evidence that health disparities for obstetric and perinatal health outcomes do not exist in immigrants relative to native Germans, but exist instead in women without post-secondary-level education compared to women with such education, regardless of ethnicity or migration history.
Authors: Samira Behboudi-Gandevani; Razieh Bidhendi-Yarandi; Mohammad Hossein Panahi; Abbas Mardani; Piret Paal; Christina Prinds; Mojtaba Vaismoradi Journal: Ann Glob Health Date: 2022-06-28 Impact factor: 3.640
Authors: Hanna M Heller; Annemijn V R de Vries; Adriaan W Hoogendoorn; Fedde Scheele; Willem J Kop; Christianne J M de Groot; Adriaan Honig; Birit F P Broekman Journal: Matern Child Health J Date: 2022-06-02