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Challenges in migrant women’s maternity care in a high-income country : A population-based cohort study of maternal and perinatal outcomes

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dc.contributor Landspitali - The National University Hospital of Iceland
dc.contributor.author Guðmundsdóttir, Embla Ýr
dc.contributor.author Gottfreðsdóttir, Helga
dc.contributor.author Hálfdánsdóttir, Berglind
dc.contributor.author Nieuwenhuijze, Marianne
dc.contributor.author Gissler, Mika
dc.contributor.author Einarsdóttir, Kristjana
dc.date.accessioned 2022-01-08T01:01:39Z
dc.date.available 2022-01-08T01:01:39Z
dc.date.issued 2021-09
dc.identifier.citation Guðmundsdóttir , E Ý , Gottfreðsdóttir , H , Hálfdánsdóttir , B , Nieuwenhuijze , M , Gissler , M & Einarsdóttir , K 2021 , ' Challenges in migrant women’s maternity care in a high-income country : A population-based cohort study of maternal and perinatal outcomes ' , Acta Obstetricia et Gynecologica Scandinavica , vol. 100 , no. 9 , pp. 1665-1677 . https://doi.org/10.1111/aogs.14186
dc.identifier.issn 0001-6349
dc.identifier.other PURE: 35282976
dc.identifier.other PURE UUID: 325a7dbb-ab38-41fc-b6be-2afbca16dbec
dc.identifier.other Scopus: 85108304892
dc.identifier.other WOSLite: 000662721800001
dc.identifier.uri https://hdl.handle.net/20.500.11815/2799
dc.description Funding Information: This work was supported by a project grant from the Icelandic Research Fund, 2019?196218-051. We thank the Icelandic Directorate of Health and the IMBR for providing the data. Funding Information: This work was supported by a project grant from the Icelandic Research Fund, 2019–196218‐051. Publisher Copyright: © 2021 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG)
dc.description.abstract INTRODUCTION: This study aims to explore maternal and perinatal outcomes of migrant women in Iceland. MATERIAL AND METHODS: This prospective population-based cohort study included women who gave birth to a singleton in Iceland between 1997 and 2018, comprising a total of 92 403 births. Migrant women were defined as women with citizenship other than Icelandic, including refugees and asylum seekers, and categorized into three groups, based on their country of citizenship Human Development Index score. The effect of country of citizenship was estimated. The main outcome measures were onset of labor, augmentation, epidural, perineum support, episiotomy, mode of birth, obstetric anal sphincter injury, postpartum hemorrhage, preterm birth, a 5-minute Apgar <7, neonatal intensive care unit admission and perinatal mortality. Odds ratios (ORs) and 95% confidence intervals (CIs) for maternal and perinatal outcomes were calculated using logistic regression models. RESULTS: A total of 8158 migrant women gave birth during the study period: 4401 primiparous and 3757 multiparous. Overall, migrant women had higher adjusted ORs (aORs) for episiotomy (primiparas: aOR 1.43, 95% CI 1.26-1.61; multiparas: 1.39, 95% CI 1.21-1.60) and instrumental births (primiparas: 1.14, 95% CI 1.02-1.27, multiparas: 1.41, 95% CI 1.16-1.72) and lower aORs of induction of labor (primiparas: 0.88, 95% CI 0.79-0.98; multiparas: 0.74, 95% CI 0.66-0.83), compared with Icelandic women. Migrant women from countries with a high Human Development Index score (≥0.900) had similar or better outcomes compared with Icelandic women, whereas migrant women from countries with a lower Human Development Index score than that of Iceland (<0.900) had additionally increased odds of maternal and perinatal complications and interventions, such as emergency cesarean and postpartum hemorrhage. CONCLUSIONS: Women's citizenship and country of citizenship Human Development Index scores are significantly associated with a range of maternal and perinatal complications and interventions, such as episiotomy and instrumental birth. The results indicate the need for further exploration of whether Icelandic perinatal healthcare services meet the care needs of migrant women.
dc.format.extent 13
dc.format.extent 1665-1677
dc.language.iso en
dc.relation.ispartofseries Acta Obstetricia et Gynecologica Scandinavica; 100(9)
dc.rights info:eu-repo/semantics/openAccess
dc.subject Fæðingarþjónusta
dc.subject Innflytjendur
dc.subject childbirth interventions
dc.subject maternal outcome
dc.subject migrant
dc.subject perinatal complications
dc.subject perinatal outcome
dc.subject Prospective Studies
dc.subject Humans
dc.subject Middle Aged
dc.subject Iceland
dc.subject Pregnancy Complications/ethnology
dc.subject Pregnancy
dc.subject Young Adult
dc.subject Maternal-Child Health Services/standards
dc.subject Adolescent
dc.subject Healthcare Disparities
dc.subject Prenatal Care/standards
dc.subject Adult
dc.subject Female
dc.subject Emigrants and Immigrants
dc.subject Infant, Newborn
dc.subject Pregnancy Outcome
dc.subject Cohort Studies
dc.subject Obstetrics and Gynecology
dc.title Challenges in migrant women’s maternity care in a high-income country : A population-based cohort study of maternal and perinatal outcomes
dc.type /dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article
dc.description.version Peer reviewed
dc.identifier.pmid 34022065
dc.identifier.doi https://doi.org/10.1111/aogs.14186
dc.relation.url http://www.scopus.com/inward/record.url?scp=85108304892&partnerID=8YFLogxK
dc.contributor.department Faculty of Nursing
dc.contributor.department Women's and Childrens's Services
dc.contributor.department Faculty of Medicine


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