Migration to western industrialised countries and perinatal health: A systematic review☆
Section snippets
Research question
Do migrant women in western industrialised countries have consistently poorer perinatal health outcomes than receiving-country women?
A secondary objective was to describe which migration and perinatal outcome indicators and related factors have been studied and how these studies were conducted.
Results
Table 1 describes the characteristics of the studies reviewed as well as the subset identified for meta-analyses. Nearly all the reports meeting our inclusion criteria were published in English. Eighteen receiving countries were represented in the review, and just over one-third of the studies concerned migrants in the United States. The review incorporated data about 20,152,134 women, with over one-third of the studies including <1000 migrants and just over one-twentieth between 1 and 2
Discussion
Our review identified numerous studies of migration and perinatal health, but heterogeneity in study design and the definitions used to define migrant groups limited the conclusions that could be drawn from them. Being a migrant was not a consistent marker of risk of poorer perinatal health outcomes; migrants did as well as or better than host-county women for all perinatal health outcomes in a large proportion of studies – indeed, for preterm birth, low birthweight and health-promoting
Conclusions
Our systematic review of published studies shows that being a migrant is not a consistent marker for risk of poor perinatal health outcomes. This review also showed, however, that some migrant women fare less well than receiving-country women; Asian, North- and other-African migrants were at greater perinatal health risk than their receiving-country counterparts in the small number of studies that could be included in meta-analyses for each subgroup. Despite the large number of studies of
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2022, Environmental AdvancesCitation Excerpt :Most studies reviewed the described suboptimal prenatal care provision and worse maternal health outcomes for migrant women, with large effect sizes attributed to organizational, socio-cultural, and communication barriers; wariness toward healthcare providers and Western medicine; and a sense of discrimination. In situations of perceived discrimination, significantly increased risks of stillbirth and perinatal mortality among migrants compared to native women (relative risk 1.7–2.8) have been described (Gagnon et al., 2009, Small et al., 2014). Asylum-seeking migrant women had greatest vulnerability to poor birth outcomes.
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This study was funded by the Canadian Institutes of Health Research (CIHR) under their International Opportunities Program (#157033) with start-up support from Immigration et métropoles (Center of Excellence in Immigration Studies – Montreal). Le fonds de la recherche en santé du Québec (FRSQ) provided career support and l'Institut national de la santé et de la recherche médicale (INSERM; France), a visiting scientist scholarship to AJG. Thanks to Hilary Elkins and Diane Habbouche for administrative support and to Francoise Maillard for database troubleshooting.