학술논문
Perinatal health outcomes of international migrant women in Brazil: A nationwide data linkage study of the CIDACS birth cohort (2011-2018).
Document Type
Academic Journal
Author
Pescarini JM; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Centre of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil. Electronic address: julia.pescarini1@lshtm.ac.uk.; Falcao IR; Centre of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.; Reboucas P; Centre of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.; Paixao ES; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Centre of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.; Sanchez-Clemente N; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Centre for Neonatal and Paediatric Infection, St. George's University London, UK.; Goes EF; Centre of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.; Abubakar I; Faculty of Population Health Sciences, University College London (UCL), London, UK.; Rodrigues LC; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Centre of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.; Brickley EB; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.; Smeeth L; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Health Data Research (HDR), London, UK.; Barreto ML; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil.
Source
Publisher: Elsevier Science Country of Publication: Netherlands NLM ID: 101230758 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-0442 (Electronic) Linking ISSN: 14778939 NLM ISO Abbreviation: Travel Med Infect Dis Subsets: MEDLINE
Subject
Language
English
Abstract
Background: We investigated perinatal outcomes among live births from international migrant and local-born mothers in a cohort of low-income individuals in Brazil.
Methods: We linked nationwide birth registries to mortality records and socioeconomic data from the CIDACS Birth Cohort and studied singleton live births of women aged 10-49 years from 1st January 2011 to 31 st December 2018. We used logistic regressions to investigate differences in antenatal care, adverse pregnancy outcomes, and neonatal (i.e., ≤28 days) mortality among international migrants compared to non-migrants in Brazil; and explored the interaction between migration, race/ethnicity and living in international border municipalities.
Results: We studied 10,279,011 live births, of which 9469 (0.1 %) were born to international migrants. Migrant women were more likely than their Brazilian-born counterparts to have a previous foetal loss (ORadj: 1.16, 1.11-1.22), a delayed start of antenatal care (i.e., beyond 1st trimester) (1.22, 95%CI:1.16-1.28), a newborn who is large for gestational age (1.29, 1.22-1.36), or a newborn with congenital anomalies (1.37, 1.14-1.65). Conversely, migrant women were less likely to deliver prematurely (0.89, 0.82-0.95) or have a low birth weight infant (0.74, 0.68-0.81). There were no differences in neonatal mortality rates between migrants and non-migrants. Our analyses also showed that, when disparities in perinatal outcomes were present, disparities were mostly concentrated among indigenous mothers in international borders and among live births of Black mothers in non-borders.
Conclusion: Although live births of international migrants generally have lower rates of adverse birth outcomes, our results suggest that indigenous and Black migrant mothers may face disproportionate barriers to accessing antenatal care.
Competing Interests: Declaration of competing interest We declare no competing interests.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Methods: We linked nationwide birth registries to mortality records and socioeconomic data from the CIDACS Birth Cohort and studied singleton live births of women aged 10-49 years from 1
Results: We studied 10,279,011 live births, of which 9469 (0.1 %) were born to international migrants. Migrant women were more likely than their Brazilian-born counterparts to have a previous foetal loss (ORadj: 1.16, 1.11-1.22), a delayed start of antenatal care (i.e., beyond 1st trimester) (1.22, 95%CI:1.16-1.28), a newborn who is large for gestational age (1.29, 1.22-1.36), or a newborn with congenital anomalies (1.37, 1.14-1.65). Conversely, migrant women were less likely to deliver prematurely (0.89, 0.82-0.95) or have a low birth weight infant (0.74, 0.68-0.81). There were no differences in neonatal mortality rates between migrants and non-migrants. Our analyses also showed that, when disparities in perinatal outcomes were present, disparities were mostly concentrated among indigenous mothers in international borders and among live births of Black mothers in non-borders.
Conclusion: Although live births of international migrants generally have lower rates of adverse birth outcomes, our results suggest that indigenous and Black migrant mothers may face disproportionate barriers to accessing antenatal care.
Competing Interests: Declaration of competing interest We declare no competing interests.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)