Abstract

To examine whether the association between women's origin and early pregnancy overweight and obesity (OW/OB) varies by length of residence in Sweden. This cross-sectional observational study used pooled Swedish population register data from 1992 to 2012. Logistic regression models were run to estimate odds ratios (OR) of early pregnancy OW/OB and 95 % confidence intervals (95 % CI), comparing Swedish-born and immigrants by length-of-residence categories while adjusting for covariates. Sweden. In total, 1 771 821 pregnant women, 315 992 of whom were immigrants. With longer residence in Sweden, more immigrant women from various origins exhibited higher odds of experiencing early OW/OB compared with Swedish-born women. Findings specifically showed increased odds of early pregnancy OW/OB with increasing length of residence for women born in Latin America, Europe-27 and Southeast Asia. For example, immigrant women from Latin America residing in Sweden for < 6 years showed similar odds as Swedish-born (OR≤ 5 years 0·92, 95 % CI 0·87, 0·98), while their longer residing counterparts showed higher odds than Swedish-born women (OR6-15 years1·21, 95 % CI 1·14, 1·28 and OR≥ 16 years 1·68, 95 % CI 1·59, 1·78). Mixed results were found for other origins. The current study suggests that host country conditions might play an important role in explaining OW/OB among some groups of immigrant women. Although further studies are needed to disentangle the mechanisms that generate these health inequalities, policy efforts should focus on immigrant reception and early integration to prevent pregnancy-related OW/OB.

Highlights

  • ResultsImmigrant women from more countries/regions of origin showed greater odds of early pregnancy overweight and obesity (OW/OB) compared with Swedish-born women when residing in Sweden for 6 to 15 years, including those from the ‘rest of Africa’ (OR 2·02 95 % CI 1·93, 2·13), Middle East (OR 1·47 95 % CI 1·43, 1·51), Latin America (OR 1·21 95 % CI 1·14, 1·28), Afghanistan (OR 1·20 95 % CI 1·04, 1·37) and ‘Oceania and North America’ (OR 1·21 95 % CI 1·06, 1·39), all of which showed increased odds compared with their more recently arrived counterparts (those in category of residence ≤ 5)

  • Immigrant women from more countries/regions of origin showed greater odds of early pregnancy overweight and obesity (OW/OB) compared with Swedish-born women when residing in Sweden for 6 to 15 years, including those from the ‘rest of Africa’, Middle East, Latin America, Afghanistan and ‘Oceania and North America’, all of which showed increased odds compared with their more recently arrived counterparts

  • Findings showed higher odds of early pregnancy OW/OB with increasing length of residence for women born in Latin America, EU-27 and Southeast Asia

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Summary

Results

Immigrant women from more countries/regions of origin showed greater odds of early pregnancy OW/OB compared with Swedish-born women when residing in Sweden for 6 to 15 years, including those from the ‘rest of Africa’ (OR 2·02 95 % CI 1·93, 2·13), Middle East (OR 1·47 95 % CI 1·43, 1·51), Latin America (OR 1·21 95 % CI 1·14, 1·28), Afghanistan (OR 1·20 95 % CI 1·04, 1·37) and ‘Oceania and North America’ (OR 1·21 95 % CI 1·06, 1·39), all of which showed increased odds compared with their more recently arrived counterparts (those in category of residence ≤ 5) This pattern extended to immigrant groups residing in Sweden for 16 years or longer, including immigrants from Latin America Immigrant women coming from Latin America and EU-27 showed increased odds of early pregnancy OW/OB with each increasing length-of-residence category, departing from similar or lower odds to higher odds than Swedish-born women (OR≤ 5 years 0·92 95 % CI 0·87, 0·98; OR6–15 years 1·21 95 %CI 1·14, 1·28; OR≥ 16 years 1·68 95 % CI 1·59, 1·78 for Latin America; and OR≤ 5 years 0·70 95 % CI 0·68, 0·73; OR6–15 years 0·87 95 % CI 0·84, 0·90; OR≥ 16 years 1·10 95 % CI 1·07, 1·14 for EU-27)

Discussion
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