Maternal Migration Status Research Articles

Effect of access to antenatal care on risk of preterm birth among migrant women in Italy: A population-based cohort study

ObjectiveTo evaluate the association between maternal migration status and preterm birth, and whether a better adherence to antenatal care during pregnancy mitigates the risk of preterm birth. DesignPopulation-based cohort. SettingAdministrative databases of the Lombardy region, Italy. PopulationFirst singleton births of women aged 15–55 years at 22–42 gestational weeks, between 2016 and 2021. MethodsAssessed the risk of preterm birth (<37 weeks). Main outcome measuresA multivariable logistic regression mediation model calculated the mediation effect of adherence to antenatal care in the association between maternal migrant status and preterm birth and the residual effect not mediated by it. Analyses were adjusted for the socio-demographic and pregnant characteristics of the women. ResultsOf 349,753 births in the cohort, Italian nationality accounted for 71 %; 28.4 % were documented migrants and 0.4 % undocumented migrants. Among them, 5.3 %, 6.4 %, and 9.3 % had a preterm birth, respectively. Using deliveries of Italian citizens as referent, migrants had a significantly increased risk of preterm birth (adjusted relative risk: 1.22, 95 % confidence interval: 1.18–1.27). Adherence to antenatal care mediated the 62 % of such risk. We have calculated that adherence to antenatal pathways set to the highest level for the whole population could lead to a 37 % reduction in preterm birth risk. ConclusionPart of the excess of preterm birth among documented and undocumented migrants in Italy can be explained by a lack of adherence to the antenatal care path despite equal access to National Health care. The adherence of all pregnant women to antenatal care would reduce the risk of preterm birth by about one-third.

Intersectional inequalities in paediatric infectious diseases: a national cohort study in Sweden

BackgroundIt is well known that socially deprived children are more likely to be hospitalised for infections. Less is known about how different social disadvantages interact. Therefore, we examine intersectional inequalities...

Maternal Migration, Prenatal Stress and Child Autistic Traits: Insights From a Population-Based Cohort Study

There is emerging evidence for an increased prevalence of autism in children of mothers with a migration background. To date, the mechanisms underlying this relationship are poorly understood. We investigated whether prenatal stress exposure mediates the association between maternal migration and child autistic traits, assessing first- and second-generation migrant mothers in the Netherlands and their children. The study was embedded in the prospective population-based Generation R cohort. Of the 4,727 participants, 1,773 mothers (38%) had a migration background. Prenatal stress was assessed using questionnaires related to stressful life events, family functioning, self-esteem, long-lasting difficulties, symptoms of psychopathology, social support, and perceived discrimination. Autistic traits were measured at age 6 years with the parent-reported Social Responsiveness Scale exclusively. Longitudinal multiple mediation analyses were performed. Analyses were stratified by migration origin (Europe and outside Europe) because of differences in migration characteristics. Maternal migration background was associated with more experienced stress and with higher child autistic trait scores (Europe: mean= 0.42, SD= 0.25; outside Europe: mean= 0.50, SD= 0.24) compared to no migration background (Netherlands: mean= 0.38, SD= 0.23; both p< .01). Prenatal stress, especially perceived discrimination and maternal psychopathology, accounted for up to half of the total effect of maternal migration, which remained after adjusting for sociodemographic factors (Bindirect= 0.035, 95% CI= 0.027, 0.043, Btotal= 0.074). Stress during pregnancy mediated the association between maternal migration status and child autistic traits. Future research should focus on early interventions to assess whether reducing prenatal stress exposure among women with a migration background can result in lower offspring autistic traits. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.

Childhood Overweight/Obesity amidst Migration, Socioeconomic Factors, and Obesogenic Behaviors: Insights from the Growing Up in New Zealand Study

Research on migration as a risk factor for obesity has produced inconsistent findings. Potential influence of migration as a social determinant of obesity has not been previously explored in New Zealand (NZ) as a migrant receiving country. This study aimed to investigate the link between maternal migration status and residential duration and childhood overweight/obesity risk in NZ, considering sociodemographic characteristics and obesogenic behaviors. Data on 5,506 4- to 5-year-old children and their mothers were taken from a large and nationally representative cohort study in NZ (the Growing Up in NZ Study). Multivariable logistic regression analyses were conducted to examine the association between maternal migration status, maternal residential duration, and child’s overweight/obesity risk and the risk of adopting obesogenic behaviors independent of socioeconomic influences. A lower proportion of children of foreign-born mothers presented with overweight/obesity (26%) at age 5 years compared with children of NZ-born mothers (29.6%) (adjusted odds ratio (AOR) 0.85, 95% confidence interval (CI) (0.74, 0.98)). Maternal residential duration had no association with children’s weight status among migrant families. Regarding obesogenic behaviors, the findings were mixed with children of foreign-born mothers having lower odds of consuming fast food (AOR 0.77, 95% CI (0.65, 0.91)) and soft drinks (AOR 0.87, 95% CI (0.76, 0.99)); however, they had higher odds of having inadequate sleep duration (AOR 2.25, 95% CI (1.85, 2.73)). The lower prevalence of overweight/obesity and lower odds of consuming fast foods and soft drinks among children of foreign-born mothers indicate potential protective factors within migrant families. However, the increased likelihood of inadequate sleep duration highlights an area of concern that warrants further attention and intervention. The findings emphasize the importance of considering diverse social determinants of health and specific risk factors when developing targeted interventions to address childhood overweight/obesity.

Infant feeding in diverse families; the impact of ethnicity and migration on feeding practices

ObjectiveTo investigate differences in infant feeding practices and styles by maternal migration status. DesignProspective cohort study. SettingMaternity unit of a large hospital in Northern England ParticipantsWomen recruited to the Born in Bradford longitudinal cohort study MeasurementsBreastfeeding initiation; breastfeeding at six months; breastfeeding at twelve months; timing of introduction of complementary feeding; maternal feeding style at twelve months. FindingsMigrant women were more likely to initiate breastfeeding and continue breastfeeding for longer compared to native women. Native women also introduced complementary feeding earlier than migrant women. There was evidence of feeding practices among second= generation migrants becoming increasingly more aligned with those of native women, with lower breastfeeding rates and earlier introduction of complementary feeding compared to first-generation migrants. Migrant women were more likely to adopt a ‘Demanding’ feeding style, with the strongest associations seen in first-generation migrants. Key conclusionsMigration status is an important factor to consider in reference to infant feeding practices. This is particularly important in considering intergenerational changes in families with migration backgrounds and the potential of culture to impact on family practices. Implications for practiceInterventions to maintain cultural norms around infant feeding in families with migration backgrounds would be beneficial, due to the observed higher rates of breastfeeding in first-generation migrants. Targeted interventions to improve breastfeeding in white British native women should consider the role that culture can play in encouraging positive health behaviours.

Care-seeking during fatal childhood illness in rural South Africa: a qualitative study

ObjectivesThis study aimed to better understand reasons why children in South Africa die at home, including caregivers’ care-seeking experiences, decision-making, choice of treatment provider and barriers to accessing care during...

1.11-P20Intergenerational transmission of health disparities among Turkish-origin residents in Germany: role of maternal stress and stress biology during pregnancy. A study protocol

Background:Turkish-origin immigrants constitute one of the biggest migration groups in Germany where they exhibit higher levels of social disadvantage when compared to the majority population. Research has elucidated the underlying mechanisms by which social disadvantage is biologically embedded to impact health over the lifespan. However, relatively little is known about how its effects are transmitted across generations. Aims of the study: To elucidate the effects of maternal migration status and socioeconomic status on stress-related maternal-placental-foetal (MPF) biological processes across gestation and on subsequent infant birth and health outcomes. Methods: We are conducting a longitudinal cohort study of N = 450 child-mother dyads with serial measures across gestation and birth through the first year of life. Our proposed study population will include approximately equal numbers of Turkish-origin women in Germany, German women in Germany, Turkish women living in Turkey and their offspring. Study visits are conducted from the second trimester of pregnancy to the end of the first year of life to assess maternal socio-economic and migration-related information, psychological well-being, nutrition, medical risk variables, and MPF stress biology markers from maternal blood and saliva samples. Infant anthropometric measures, developmental outcomes and stress markers in saliva are assessed throughout the first year of life. Analyses: We will test specific hypotheses regarding the association between migration background, socioeconomic status and MPF stress biology. We will furthermore quantify the association of maternal migration background- and social disadvantage-related MPF stress biology measures on pregnancy and child health outcomes. Discussion: This is the first study on foetal programming of health disparities with a focus on Turkish-origin women in Germany. The significance and impact of this study derives from the importance of achieving a better understanding of underlying mechanisms that alter disease vulnerability in minority and disadvantaged populations.

Body mass index development from birth to early adolescence; effect of perinatal characteristics and maternal migration background in a Swedish cohort.

BackgroundWell documented diversity in risk of developing overweight and obesity between children of immigrant and of native mothers, might be explained by different body mass index (BMI) development trajectories in relation to maternal and perinatal characteristics of offspring.ObjectivesTo assess BMI development trajectories among children born to immigrant and to Swedish mothers from birth to adolescence in relation to perinatal characteristics.MethodsA cohort of 2517 children born in Stockholm during 1994 to 1996 was followed with repeated measurement of height and weight at eleven time points until age 12 years. We estimated changes over time for BMI in relation to maternal and perinatal characteristics of offspring using mixed linear model analysis for repeated measure data.ResultsWe observed a significant BMI change over time in children and time interaction with maternal migration status (P<0.0001). Estimated BMI over time adjusted for maternal and perinatal characteristics of offspring, showed slower BMI growth before age of 5, followed by an earlier plateau and steeper BMI growth after 5 years among children of immigrant mothers compared with children of Swedish mothers. These differences in BMI growth were more prominent among children with mothers from outside Europe.ConclusionBeside reinforcing early childhood as a crucial period in development of overweight, the observed slower BMI development at early childhood among children of immigrants followed by a steeper increase in BMI compared with children of Swedish mothers is important for further studies and for planning of preventive public health programs.

Migration and Infant Death: Assimilation or Selective Migration among Puerto Ricans?

Using pooled origin/destination data from the Puerto Rican Maternal and Infant Health Study the authors examine the implications for infant mortality of migration from Puerto Rico to the US. An analysis restricted to the US mainland shows that children of migrants have lower risks of infant mortality than do children of mainland-born Puerto Rican women. A critical question is whether this pattern indicates that maternal exposure to US culture undermines infant health or whether it is largely a result of the selective migration of healthier or more advantaged mothers to the US. The authors findings show that mothers duration of US residence is positively related to infant mortality among the children of migrants suggesting that a process of negative assimilation is occurring. However inclusion of Puerto Rico in the analysis demonstrates the importance of selective migration in explaining the US mainland pattern: Infant mortality is substantially lower among recent migrants to the mainland than it is among nonmigrant women in Puerto Rico. The roles of socioeconomic status cultural orientation health habits and health care utilization in accounting for differences in infants survival chances by maternal migration status are assessed. (authors)

Migration and Infant Death: Assimilation or Selective Migration among Puerto Ricans?

Using pooled origin/destination data from the Puerto Rican Maternal and Infant Health Study, we examine the implications for infant mortality of migration from Puerto Rico to the United States. An analysis restricted to the U.S. mainland shows that children of migrants have lower risks of infant mortality than do children of mainland-born Puerto Rican women. A critical question is whether this pattern indicates that maternal exposure to U.S. culture undermines infant health or whether it is largely a result of the selective migration of healthier or more advantaged mothers to the United States. Our findings show that mother's duration of U.S. residence is positively related to infant mortality among the children of migrants, suggesting that a process of negative assimilation is occurring. However, inclusion of Puerto Rico in the analysis demonstrates the importance of selective migration in explaining the U.S. mainland pattern: Infant mortality is substantially lower among recent migrants to the mainland than it is among nonmigrant women in Puerto Rico. The roles of socioeconomic status, cultural orientation, health habits, and health care utilization in accounting for differences in infants’ survival chances by maternal migration status are assessed.