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      International migration and adverse birth outcomes: role of ethnicity, region of origin and destination

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          Abstract

          Background

          The literature on international migration and birth outcomes shows mixed results. This study examined whether low birth weight (LBW) and preterm birth differed between non-migrants and migrant subgroups, defined by race/ethnicity and world region of origin and destination.

          Methods

          A systematic review and meta-regression analyses were conducted using three-level logistic models to account for the heterogeneity between studies and between subgroups within studies.

          Results

          Twenty-four studies, involving more than 30 million singleton births, met the inclusion criteria. Compared with US-born black women, black migrant women were at lower odds of delivering LBW and preterm birth babies. Hispanic migrants also exhibited lower odds for these outcomes, but Asian and white migrants did not. Sub-Saharan African and Latin-American and Caribbean women were at higher odds of delivering LBW babies in Europe but not in the USA and south-central Asians were at higher odds in both continents, compared with the native-born populations.

          Conclusions

          The association between migration and adverse birth outcomes varies by migrant subgroup and it is sensitive to the definition of the migrant and reference groups.

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          Current methods of the US Preventive Services Task Force: a review of the process.

          C D Mulrow, , Jennifer Atkins … (2001)
          The U.S. Preventive Services Task Force (USPSTF/Task Force) represents one of several efforts to take a more evidence-based approach to the development of clinical practice guidelines. As methods have matured for assembling and reviewing evidence and for translating evidence into guidelines, so too have the methods of the USPSTF. This paper summarizes the current methods of the third USPSTF, supported by the Agency for Healthcare Research and Quality (AHRQ) and two of the AHRQ Evidence-based Practice Centers (EPCs). The Task Force limits the topics it reviews to those conditions that cause a large burden of suffering to society and that also have available a potentially effective preventive service. It focuses its reviews on the questions and evidence most critical to making a recommendation. It uses analytic frameworks to specify the linkages and key questions connecting the preventive service with health outcomes. These linkages, together with explicit inclusion criteria, guide the literature searches for admissible evidence. Once assembled, admissible evidence is reviewed at three strata: (1) the individual study, (2) the body of evidence concerning a single linkage in the analytic framework, and (3) the body of evidence concerning the entire preventive service. For each stratum, the Task Force uses explicit criteria as general guidelines to assign one of three grades of evidence: good, fair, or poor. Good or fair quality evidence for the entire preventive service must include studies of sufficient design and quality to provide an unbroken chain of evidence-supported linkages, generalizable to the general primary care population, that connect the preventive service with health outcomes. Poor evidence contains a formidable break in the evidence chain such that the connection between the preventive service and health outcomes is uncertain. For services supported by overall good or fair evidence, the Task Force uses outcomes tables to help categorize the magnitude of benefits, harms, and net benefit from implementation of the preventive service into one of four categories: substantial, moderate, small, or zero/negative. The Task Force uses its assessment of the evidence and magnitude of net benefit to make a recommendation, coded as a letter: from A (strongly recommended) to D (recommend against). It gives an I recommendation in situations in which the evidence is insufficient to determine net benefit. The third Task Force and the EPCs will continue to examine a variety of methodologic issues and document work group progress in future communications.
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            Birth outcomes for Arabic-named women in California before and after September 11.

            Diane S. Lauderdale (2006)
            Persons who were perceived to be Arabs experienced a period of increased harassment, violence, and workplace discrimination in the United States in the weeks immediately following September 11, 2001. Drawing on prior studies that have hypothesized that experiences of discrimination increase the risk of preterm birth and low birth weight, this study explores whether there was an effect on birth outcomes for pregnant women of Arab descent. California birth certificate data are used to determine the relative risk of poor birth outcomes by race, ethnicity, and nativity for women who gave birth in the six months following September 2001, compared with the same six calendar months one year earlier. The relative risk of poor birth outcomes was significantly elevated for Arabic-named women and not for any of the other groups.
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              Pregnancy outcome of migrant women and integration policy: a systematic review of the international literature.

              Paola Bollini, Sandro Pampallona, Philippe Wanner … (2009)
              Immigrant mothers in developed countries often experience worse pregnancy outcomes than native women. Several epidemiological studies have described the pregnancy outcome of immigrant women in European receiving countries, with conflicting results. The present systematic review makes a quantitative synthesis of available evidence on the association between pregnancy outcomes and integration policies. We reviewed all epidemiological studies comparing the pregnancy outcome of native versus immigrant women in European countries from 1966 to 2004 and retained 65 for analysis, from 12 host countries. Overall, as compared to native women, immigrant women showed a clear disadvantage for all the outcomes considered: 43% higher risk of low birth weight, 24% of pre-term delivery, 50% of perinatal mortality, and 61% of congenital malformations. The risks were clearly and significantly reduced in countries with a strong integration policy. This trend was maintained even after adjustment for age at delivery and parity. On the basis of an analysis of naturalisation rates, five countries in our sample could be categorised as having a strong policies promoting the integration of immigrant communities. The mechanisms through which integration policies may be protective include the increased participation of immigrant communities in the life of the receiving society, and the decreased stress and discrimination they may face. The results of this study highlight a serious problem of equity in perinatal health across European countries. Immigrant women clearly need targeted attention to improve the health of their newborn, but a deep societal change is also necessary to integrate and respect immigrant communities in receiving societies.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Epidemiol Community Health
                Journal ID (publisher-id): jech
                Journal ID (hwp): jech
                Title: Journal of Epidemiology and Community Health
                Publisher: BMJ Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Print): 0143-005X
                ISSN (Electronic): 1470-2738
                Publication date (Electronic): 4 March 2010
                Publication date (Print): March 2010
                Publication date PMC-release: 4 March 2010
                Volume: 64
                Issue: 3
                Pages: 243-251
                Affiliations
                [1 ]Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Canada
                [2 ]Institute for Clinical Evaluative Sciences, Toronto, Canada
                [3 ]Epidemiological Research Unit on Perinatal Health and Women's Health (INSERM), Paris, France
                [4 ]National Research and Development Centre for Welfare and Health (STAKES), Helsinki, Finland
                [5 ]City University, London, UK
                [6 ]Statistics Canada, Ottawa, Canada
                [7 ]Faculty of Nursing, University of Manitoba, Winnipeg, Canada
                [8 ]University of Oslo, Rikshospitalet, Oslo, Norway
                [9 ]McGill University/MUHC, Montreal, Canada
                Author notes
                Correspondence to Dr Marcelo Luis Urquia, Centre for Research on Inner City Health, St Michael's Hospital, 70 Richmond Street E, 4th Floor, Toronto, ON M5C 1N8, Canada; marcelo.urquia@ 123456utoronto.ca
                [*]

                See end of paper for members of the ROAM collaboration.

                Article
                Publisher ID: jech083535
                DOI: 10.1136/jech.2008.083535
                PMC ID: 2922721
                PubMed ID: 19692737
                SO-VID: c8e048e3-819c-45a4-8d93-4e049cae5677
                Copyright © © 2009, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

                History
                Date accepted : 16 May 2009
                Categories
                Subject: Research Report
                Subject: 1506

                ScienceOpen disciplines: Public health
                Keywords: preterm birth,meta-analysis me,low birth weight,ethnicity,multilevel modelling,perinatal cg,migration and health
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: preterm birth, meta-analysis me, low birth weight, ethnicity, multilevel modelling, perinatal cg, migration and health

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