Preterm subtypes by immigrants’ length of residence in Norway: a population-based study

BMC Pregnancy and Childbirth

Siri Vangen³  Johanne Sundby⁴  Anne K Daltveit²  Ingvil K Sørbye¹ 

[1] Norwegian Resource Centre for Women’s Health, Women and Children’s Division, Oslo University Hospital, P.O. Box 4950 Nydalen, Oslo 0424, Norway;Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway;Norwegian Institute of Public Health, Oslo, Norway;Institute of Health and Society, University of Oslo, Oslo, Norway

关键词: Iatrogenic preterm delivery;    Non-spontaneous preterm delivery;    Spontaneous preterm delivery;    Country of birth;    Length of residence;    Immigrants;    Preterm delivery;   

Others  :  1127120
DOI  :  10.1186/1471-2393-14-239

 received in 2014-04-25, accepted in 2014-07-18,  发布年份 2014

【 摘 要 】

Background

The reduction of the preterm delivery (PTD) rate is a maternal and child health target. Elevated rates have been found among several immigrant groups, but few studies have distinguished between PTD according to the mode of birth start. In addition, migrants’ birth outcomes have further been shown to be affected by the time in residence; however, the association to PTD subtypes has not previously been assessed. In this study we examined if the risk of spontaneous and non-spontaneous, or iatrogenic, PTD among immigrants in Norway varied according to the length of residence and the country of birth, and compared with the risks among the majority population.

Methods

We linked population-based birth and immigration data for 40 709 singletons born to immigrant women from Iraq, Pakistan, the Philippines, Somalia, Sri Lanka and Vietnam and 868 832 singletons born to non-immigrant women from 1990–2009. Associations between the length of residence and subtypes of PTD were estimated as relative risks (RRs) with 95% confidence intervals (CIs) from multivariable models.

Results

In total, 48 191 preterm births occurred. Both spontaneous and non-spontaneous PTD rates were higher among immigrants (4.8% and 2.0%) than among non-immigrants (3.6% and 1.6%). Only non-spontaneous PTD was associated with longer lengths of residence (p trend <0.001). Recent immigrants (<5 years of residence) and non-immigrants had a similar risk of non-spontaneous PTD, whereas immigrants with lengths of residence of 5–9 years, 10–14 years and ≥15 years had adjusted RRs of 1.18 [95% CI 1.03,1.35], 1.43 [95% CI 1.20,1.71] and 1.66 [95% CI 1.41,1.96]. The association was reduced after further adjustments for maternal and infant morbidity. Conversely, the risk of spontaneous PTD among immigrants was not mitigated by length of residence, but varied with country of birth according to the duration of pregnancy in term births.

Conclusions

Non-spontaneous PTD increased with the length of residence whereas spontaneous PTD remained elevated regardless of the length of residence. Policies to improve birth outcomes in ethnically mixed populations should address the modifiable causes of PTD rather than aiming to reduce absolute PTD rates.

【 授权许可】

   
2014 Sørbye et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

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