Adverse birth outcomes among native-born and foreign-born mothers in Taiwan: A population-based birth cohort study

BMC Pregnancy and Childbirth

Tung-liang Chiang¹  Laura Wen-Shuan Shiao¹ 

[1] Institute of Health Policy and Management, College of Public Health, National Taiwan University, Room 620, No.17, Hsu-Chow Rd, Taipei, Taiwan

关键词: Healthy migrant effect.;    Epidemiological paradox;    Socioeconomic position;    Foreign-born;    Preterm birth;    Low birth weight;   

Others  :  1152200
DOI  :  10.1186/1471-2393-12-110

 received in 2011-05-02, accepted in 2012-10-08,  发布年份 2012

【 摘 要 】

Background

The number of children born to foreign-born mothers in Taiwan has significantly increased since the 1990s. These foreign-born mothers are mainly from China and Southeast Asia. Children born to foreign-born mothers, according to media reports, are subject to inferior health. This study sought to determine whether socioeconomic disparities in birth outcomes exist between native and foreign-born mothers in Taiwan.

Methods

Analysis data were obtained from the Taiwan Birth Cohort Study of 20,090 nationally representative 6-month-old babies, born in 2005. The data on the babies were divided into two groups, those of foreign-born mothers and those of Taiwanese mothers. The health outcome variables that were examined included two adverse birth outcomes: low birth weight and preterm birth. Multiple logistic regression was used to examine the association between income and foreign-born status, as well as birth outcomes among both groups.

Results

Children of native Taiwanese mothers had a higher prevalence of low birth weight (6.9%) than did children of China-born (4.7%) and Southeast Asia-born mothers (5.2%). The prevalence of preterm birth was also higher among children of native Taiwanese mothers (8.4%) than among children of Southeast Asia-born (7.2%) and China-born mothers (6.3%). Foreign-born status was associated with lower odds of low birth weight among families with a monthly family income < NT$30,000 (adjusted odds ratio (AOR) = 0.24, 95% confidence interval (CI) = 0.14–0.42, p < 0.001), and lower odds of preterm birth among families with a monthly family income < NT$30,000 and NT$30,000–69,999 (AOR = 0.63, CI = 0.40–0.99, p < 0.05, and AOR = 0.68, CI = 0.53–0.88, p < 0.01, respectively). Having a higher monthly family income (NT$70,000+ and NT$30,000–69,999) was associated with lower odds of low birth weight (AOR = 0.59, CI = 0.46–0.77, p < 0.001 and AOR = 0.75, CI = 0.60–0.94, p < 0.05, respectively) among Taiwanese mothers, but not among foreign-born mothers.

Conclusion

Foreign-born mothers from China and Southeast Asia did not experience worse birth outcomes than native Taiwanese mothers did, regardless of the disadvantaged socioeconomic position of their families.

【 授权许可】

   
2012 Shiao and Chiang.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]E-Stat, Portal Site of Official Statistics of Japan: Vital statistics of Japan. 2010. http://www.e-stat.go.jp/SG1/estat/GL08020103.do?_toGL08020103_&listID=000001082331&requestSender=dsearch webcite.
• [2]Statistics Korea: Marriage and Divorce Statistics in 2011. 2011. http://kostat.go.kr/portal/english/news/1/8/index.board?bmode=read&bSeq=&aSeq=256079&pageNo=1&rowNum=10&navCount=10&currPg=&sTarget=title&sTxt= webcite.
• [3]Lee HK: Family migration issues in the North East Asia, background paper for the World Migration Report 2010. Geneva: International Organization for Migration; 2010.
• [4]Ministry of the Interior: Statistics on registered marriages with foreigners. Taiwan; 2012. http://www.immigration.gov.tw/public/Attachment/24241449910.xls webcite.
• [5]Chen Y: The significance of cross-border marriage in a low fertility society. Journal of Comparative Family Studies 2008, 39:331-352.
• [6]Ministry of the Interior: Weekly release, week 32. Taiwan; 2010. http://sowf.moi.gov.tw/stat/week/week9932.doc webcite.
• [7]Hsia HC: Imaged and imagined threat to the nation: the media construction of the "foreign brides' phenomenon" as social problems in Taiwan. Inter-Asia Cultural Studies 2007, 8:55-85.
• [8]Tseng YF, In Asian Cross-border Marriage Migration: Demographic Patterns and Social Issues: Marriage migration to East Asia: current issues and proposition in making comparisons. Amsterdam: IIAS, Amsterdam University Press: Edited by Yang WS, Lu MCW; 2010:31-45.
• [9]Ministry of the Interior: Fertility rates of childbearing age women 1951–2011. Taiwan; 2012. http://sowf.moi.gov.tw/stat/year/y02-04.xls webcite.
• [10]Ministry of the Interior: Weekly release, week 6. Taiwan; 2010. http://sowf.moi.gov.tw/stat/week/week9906.doc webcite.
• [11]Singh G, Yu SM: Adverse pregnancy outcomes: differences between US- and foreign-born women in major US racial and ethnic groups. Am J Public Health 1996, 86:837-843.
• [12]Fuentes-Afflick E, Hessol NA, Pérez-Stable EJ: Testing the epidemiologic paradox of low birth weight in Latinos. Arch Pediatr Adolesc Med 1999, 153:147-53.
• [13]Acevedo-Garcia D, Soobader MJ: Berkman, LF: The Differential Effect of Foreign-Born Status on Low Birth weight by Race/Ethnicity and Education. Pediatrics 2005, 115:e20-e30.
• [14]Gould JB, Maden A, Qin C, Chavez G: Perinatal outcomes in two dissimilar immigrant populations in the Unites States: a dual epidemiologic paradox. Pediatrics 2003, 111:e676-e682.
• [15]Guendelman S, Buekens P, Blondel B, Kaminski M, Notzon F, Masuy-Stroobant G: Birth outcomes of immigrant women in the United States, France, and Belgium. Matern Child Health J 1999, 3:177-187.
• [16]See LC, Shen YM, Lin SR: Lower early neonatal mortality among singletons in transnational marriage families: Taiwan birth registry. Eur J Epidemiol 2008, 23:483-489.
• [17]Xirasagar S, Fu JC, Liu J, Probst JC, Lin DP: Neonatal outcomes for immigrant vs. native-Born mothers in Taiwan: an epidemiological paradox. Matern Child Health J 2011, 15–2:269-279.
• [18]Liu C, Chang N, Chou P: Testing the "epidemiologic paradox" of birth outcomes among Asian immigrant women in Hsin-Chu County, Taiwan. J Formos Med Assoc 2008, 107:782-790.
• [19]See LC, Shen YM, Lo YJ: The differential effect of foreign-born status on preterm birth: a Taiwan population-based birth registry study. BJOG 2007, 114:1023-1027.
• [20]Gagnon AJ, Zimbeck M, Zeitlin J, The ROAM Collaboration: Migration to western industrialised countries and perinatal health: a systematic review. Soc Sci Med. 2009, 69–6:934-946.
• [21]Exchange rate in 2005, Central Bank of Republic of China Taiwan; 2005. http://www.cbc.gov.tw/content.asp?CuItem=27029 webcite.
• [22]Holm S: A simple sequentially rejective multiple test procedure. Scan J Statist 1979, 6:65-70.
• [23]Auger N, Luo Z, Platt RW, Daniel M: Do mother's education and foreign born status interact to influence birth outcomes? Clarifying the epidemiological paradox and the healthy migrant effect. J Epidemiol Community Health 2008, 62:402-409.
• [24]Kramer MS, Séguin L, Lydon J, Goulet L: Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol 2000, 14:194-210.
• [25]Feldman PJ, Dunkel-Schetter C, Sandman CA, Wadhwa PD: Maternal social support predicts birth weight and fetal growth in human pregnancy. Psychosom Med 2000, 62–5:715-725.
• [26]House JS, Williams DR, In Health and social justice: politics, ideology, and inequality in the distribution of disease: Understanding and reducing socioeconomic and racial/ethnic disparities in health. San Francisco: Jossey-Bass: Edited by Hofrichter, R; 2003:89-131.
• [27]Geronimus AT, In Race, ethnicity, and health: Black-White differences in the relationship of maternal age to birth weight. San Francisco: Jossey-Bass: Edited by LaVeist TA; 2002:213-230.
• [28]Wingate MS, Alexander GR: The healthy migrant theory: variations in preganacy outcomes among US-born migrants. Soc Sci Med 2006, 62:491-498.
• [29]Huang IT, Fang LJ, Huang CP, Hsu SP, Chu CH: Gestational Diabetes Mellitus in Taiwan. Taipei City Med J 2005, 2–2:132-137.
• [30]Jou HJ, Hung HW, Yan YH, Wu SC: Risk factors for blood transfusion in singleton pregnancy deliveries in Taiwan. Int J Gynaecol Obstet 2012, 117:124-127.
• [31]Shen TM, See LC, Lin SR: Birth weight among singletons born to foreign-born mothers in Taiwan: a population-based birth registry study. J Epidemiol 2009, 19–3:152-160.