The impact of migration background on maternal near miss

Purpose (1) To evaluate the association between immigration background and the occurrence of maternal near miss (MNM). (2) To identify medical co-factors, health-care utilization, and health-care disparities as explanations of a possibly higher risk of MNM among immigrants. Methods We compared perin...

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Bibliographic Details
Published in:Archives of gynecology and obstetrics 2019-08, Vol.300 (2), p.285-292
Main Authors: David, Matthias, Razum, Oliver, Henrich, Wolfgang, Ramsauer, Babett, Schlembach, Dietmar, Breckenkamp, Jürgen
Format: Article
Language:English
Subjects:
Acculturation
Adolescent
Adult
Emigration and Immigration
Endocrinology
Female
Gynecology
Health risk assessment
Health services utilization
Human Genetics
Humans
Immigration policy
Maternal-Fetal Medicine
Medicine
Medicine & Public Health
Near Miss, Healthcare - standards
Noncitizens
Obstetrics/Perinatology/Midwifery
Pregnancy
Pregnancy Complications - epidemiology
Prospective Studies
Young Adult
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Summary:Purpose (1) To evaluate the association between immigration background and the occurrence of maternal near miss (MNM). (2) To identify medical co-factors, health-care utilization, and health-care disparities as explanations of a possibly higher risk of MNM among immigrants. Methods We compared perinatal outcomes between immigrant women (first- or second-generation) versus non-immigrant women, delivering at three maternity hospitals in Berlin, Germany, 2011–2012. Near-miss events were defined as: HELLP syndrome, eclampsia, the occurrence or threat of uterine rupture, postpartum hemorrhage (PPH) > 1000 ml, sepsis, peripartal hysterectomy, cardiovascular complications, lung embolism. Logistic regression analyses were performed to determine the associations of immigration status, acculturation, and language competency with near-miss events, and of near-miss events with the perinatal outcomes. Results The databank included 2647 first-generation immigrants, 889 second-generation immigrants, and 3231 women without an immigration background (total N  = 6767). Near-miss events occurred in 141 women. The likelihood of near-miss events was lower among multiparous women (OR 0.6; 95% CI 0.42–0.87; p  = 0.01). No other factors had a statistically significant influence. Near-miss events are associated with an elevated likelihood for an unfavorable perinatal condition: the ORs ranged from 2.15 for an arterial umbilical cord pH value 
ISSN:0932-0067
1432-0711
DOI:10.1007/s00404-019-05179-9