Abstract
Background The risk of unfavourable pregnancy outcomes for immigrant mothers varies according to their birthplace, socioeconomic status (SES) and comparison group. This study aims to identify the characteristics of Montreal newborns who are more or less at risk of LBW, prematurity and SGA, according to the mother's birthplace and SES. Methods The analysis focuses on all singleton live births in Montreal between 2003 and 2012 (N=214,620). Logistic regression models were estimated using generalized estimating equations in order to: 1) compare the risk of adverse pregnancy outcomes between Canadian-born and immigrant mothers. The latter were categorised into 8 groups according to world regions; 2) estimate the odds ratio of the association between adverse pregnancy outcomes and the mother's SES (education and income quintile) for each group. Results The risk of LBW, prematurity and SGA vary considerably depending on the mother’s birthplace. For these three outcomes, mothers from the Caribbean and South Asia have a higher prevalence than all other groups. Three other groups compare favourably to Canadian-born mothers: mothers from North Africa, Europe & the USA, and Central and West Asia. The association between SES and unfavourable pregnancy outcomes varies from one group of mothers to another. Among Canadian-born mothers, there is a classic health gradient, with low SES mothers being particularly vulnerable. While income is not associated with the risk of adverse outcomes among immigrant mothers, education is for many groups. The association is however weaker than for Canadian-born mothers. Conclusions It is important to assess the influence of both immigration and SES to better identify the children who are most at risk of experiencing perinatal health concerns. In Montreal, some immigrant women are particularly vulnerable, but so are socioeconomically disadvantaged native Canadian women. Conversely, North African-born mothers with low SES present a particularly low risk. It has also been found that a high level of education reduces the risk among several groups of immigrant women, as opposed to findings in other contexts.
Contribution of overweight/obesity to adverse pregnancy outcomes in immigrant and non-immigrant women