The association between maternal country of birth and neonatal intensive care unit outcomes

Abstract

BackgroundImmigration is increasingly common worldwide and its impact on neonatal intensive care unit outcomes is uncertain. AimsTo determine the outcomes of children of immigrant mothers admitted to NICUs in New South Wales (NSW), Australia, between 2000 and 2006. Study designRecord linkage study of routinely collected state-based health databases. SubjectsInfants of Australian-born (9813, 81.9%) and overseas born mothers (2166, 18.1%). Outcome measuresNICU and childhood outcomes to a maximum 5years of age. ResultsImmigrant mothers came from 122 countries, 897 (44%) from high income regions. Australian born mothers were more likely to be teenaged (Odds Ratio, 95% confidence interval: 3.07, 2.21–4.26), use drugs (3.55, 2.49–5.06) and suffer an antepartum hemorrhage (1.29, 1.14–1.48). They were less likely to have gestational diabetes (0.45, 0.38–0.54), fetal distress (0.75, 0.66–0.85) and intrauterine growth restriction (0.80, 0.67–0.93). Their infants were more likely to be admitted to the NICU for prematurity but less likely to have low 5min Apgar scores (0.81, 0.69–0.93) or a congenital abnormality (0.79, 0.70–0.90). Infants of Middle-Eastern mothers had the lowest hospital survival rate (88.5%). Children of immigrant Asian mothers were least likely to be rehospitalized after NICU discharge (1.66, 1.27–2.17). ConclusionsNICU outcomes are affected by maternal country of birth even within the same ethnic group. Further study regarding the impact of paternal race and immigration status and duration of residency will provide data for the changing cultural environment of global perinatal care.