Maternal and perinatal health in undocumented migrants: estimating access and outcomes through HMIS

Background Vulnerability and inequality are exacerbated in undocumented migrants, the most invisible to health systems. Objectives To estimate maternal and perinatal health needs in undocumented migrants and test a methodology for systematic monitoring & evaluation. Methods Population-based retr...

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Bibliographic Details
Published in:European journal of public health 2022-10, Vol.32 (Supplement_3)
Main Authors: Genovese, E, Cantarutti, A, Corrao, G, Locatelli, A
Format: Article
Language:English
Subjects:
Apgar score
Birth weight
Cesarean section
Demographics
Gestational age
Growth rate
Health care industry
Health education
Health promotion
Hemorrhage
Information management
Laboratory tests
Low birth weight
Management information systems
Migrants
Neonates
Population studies
Public health
Registration
Small for gestational age
Telemedicine
Ultrasonic imaging
Undocumented immigrants
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Summary:Background Vulnerability and inequality are exacerbated in undocumented migrants, the most invisible to health systems. Objectives To estimate maternal and perinatal health needs in undocumented migrants and test a methodology for systematic monitoring & evaluation. Methods Population-based retrospective cohort study based on routine data through maternity records and temporary registration code in a sub-national Health Management Information System. Results 420924 deliveries including 1524 undocumented migrants having accessed maternity care through the NHS in Lombardy Region (Italy) from 2016 to 2021 were included. Demographics and social determinants: undocumented migrants were born in Europe (non-EU) (36%), Americas (30%), Africa (6%), Western Pacific (3%), South-East Asia (2%), Italy (2%), were stateless (7%); 52% had no/low schooling, 92% were unemployed and 52% non-married, compared to 15%, 20%, and 44% Italians. Obstetric history and antenatal care: 22% undocumented migrants had a previous abortion and 15% a previous cesarean delivery; 58% had ≥5 antenatal visits, 67% first ANC visit in trimester 1, 64% ≥ 2 ultrasounds incl. first in trimester 1, 6% full laboratory tests, compared to 90%, 97%, 97%, and 66% Italians. Intra-partum and perinatal care: 45% undocumented migrants delivered in a public hospital with neonatal intensive care unit; 69% had a normal delivery, 5% instrumental delivery, 10% and 27% emergency and total cesarean section; 2.6% neonates had emergency resuscitation and 49% were breastfed
ISSN:1101-1262
1464-360X
DOI:10.1093/eurpub/ckac131.527