Non-immigrant Mothers Research Articles

The Experience of Postnatal Depression in Immigrant Mothers Living in Western Countries: A Meta-Synthesis.

Postnatal depression affects women from all cultures and countries. The postnatal period is thought to be a vulnerable time for all mothers. Immigrant women may be at particular risk as they attempt to adhere to childbirth rituals in western societies which might exacerbate stress, while navigating through the multiple stressors they face from migration in the transition to motherhood. This study utilized a meta-synthesis approach to synthesize qualitative studies exploring postnatal depression in immigrant mothers living in western countries. Searching six databases identified 16 studies that met criteria. The synthesis revealed two overarching themes of migration and cultural influences on immigrant mothers that interact and give rise to psychosocial understandings of postnatal depression, remedies and healthcare barriers. Mothers used self-help coping strategies in line with this. Immigrant mothers living in western countries are subject to multifactorial stressors following childbirth, increasing their susceptibility to postnatal depression. These stressors relate to being an immigrant in a western society and cultural influences, which may be harder to comply with, when removed from their sociocultural context. Social support appears to play a mediating role for these immigrant mothers. There were several similarities between immigrant and non-immigrant mothers including their views of healthcare and medication, their health-seeking behaviours and their fears of having their baby removed. All these findings have implications for healthcare settings in terms of assessments and service delivery. Copyright © 2016 John Wiley & Sons, Ltd. In this meta-synthesis, we explored the experience of postnatal depression in immigrant women living in western countries, including the UK, the USA and Canada. Sixteen qualitative studies were reviewed, and their methodological quality was examined. The findings are based a total sample of 337 women. Two overarching themes were identified that are termed 'cultural influences' and 'migration factors', which influenced how these mothers coped with their postnatal depression. Social support played a mediating role for these immigrant mothers.

Immigrant Mothers’ Knowledge of Medication Safety and Administration for Young Children

The goals of this paper are to compare immigrant (Southeast Asian and Chinese) and non-immigrant (Taiwanese) mothers’ knowledge of medication safety and administration for children, and to reveal how the accessibility of medical resources could affect immigrant mothers’ medication administration. The medication knowledge and communication ability of immigrants are suggested to be insufficient, which could be the main reason for medication errors. When medical resources can be accessed easily, immigrant mothers’ medication errors may be reduced. A survey with stratified sampling was used. Data were gathered from 643 participants with young children in Taiwan. A researcher-designed questionnaire was used to solicit participants’ responses concerning medication preservation and medication administration. Southeast Asian mothers need the help of doctors or family members; they frequently administer suppositories to febrile children, store children’s medication in the fridge, and pay less attention to the expiry date. Chinese immigrant mothers tend to let children take Chinese medicine, give previously prescribed drugs to sick children, give other children’s medication to sick children, and buy medicines at a pharmacy without a doctor’s prescription. When the participants spend more than 31 minutes travelling to the nearest clinic, they are more likely to misuse medication, such as giving previously prescribed drugs to a sick child, and combining medication with Chinese medicine. The findings of this study suggest that the medication knowledge and administration habits of immigrant and non-immigrant mothers differ. The parents of young children take sick children to seek proper medical treatment when they are able to easily access medical resources.

TESTING THE EFFECT OF THE EPIDEMIOLOGIC PARADOX: BIRTH WEIGHT OF NEWBORNS OF IMMIGRANT AND NON-IMMIGRANT MOTHERS IN THE REGION OF VALENCIA, SPAIN

The epidemiological paradox and 'healthy migrant effect' refer to the favourable health outcomes in unprivileged groups under unfavourable socioeconomic conditions. Weight at birth is associated with the epidemiological paradox. However, differences in fertility structure (mainly mother's age and first maternity) might be the cause of the difference in weight at birth between children of immigrant and non-immigrant mothers. This paper aims to analyse the impact of the epidemiologic paradox by distinguishing between the factors related to fertility structure, in addition to other socio-cultural factors. The importance of fertility structure as the cause of weight-at-birth differences of the newborns of immigrant and non-immigrant women, and between those of subgroups of immigrant mothers, is tested. Based on data from birth registries for the period 1998-2009, a variance analysis was performed for Spanish mothers and for those of five major immigrant subgroups living in the region of Valencia, Spain, which experienced significant migrant inflows within a short period of time. A Scheffé test between pairs of nationalities was carried out. Finally, linear regression models were built. The results suggest that the most relevant factors are those related to fertility structure, and that consequently the epidemiological paradox does not apply for immigrant mothers as a whole, although Bolivian immigrant offspring may be an exception. This unexpected result requires further research to test to what extent this is due to the special adaptation of multigenerational high-altitude populations in pregnancy. The factors associated with fertility structure must be controlled when trying to relate birth weight differences between ethnic groups to socioeconomic factors.

Disparities in Detection and Treatment History Among Mothers With Major Depression in Los Angeles

We sought to determine disparities in detection and treatment histories among a group of racial and ethnically diverse mothers with major depression. Our sample included 276 racially and ethnically diverse mothers who participated in the Los Angeles Family and Neighborhood Survey and who were classified with major depression based on the Comprehensive International Diagnostic Interview-Short Form. We used logistic regression to assess the association between demographic factors and previous detection with major depression, mental health specialty use, and the use of a primary care physician among these women. The demographic factors examined included race and ethnicity, immigration status, marital status, education, income, body mass index (BMI), maternal age, number of children, children's ages, history of emotional problems, and history of diabetes. Results indicated that 69% of mothers had not been previously detected with major depression nor had they sought mental health treatment in the 12 months before the interview. The odds of having been previously diagnosed with major depression were significantly higher among White and single mothers, as well as among mothers with higher BMIs and those with a history of emotional problems. Nonimmigrant mothers without emotional problems had a higher odds of having seen a mental health specialist in the 12 months before the interview compared with immigrant mothers without emotional problems; no differences in mental health treatment were found between nonimmigrant and immigrant mothers with emotional problems. Finally, African-American mothers and those with a history of diabetes had significantly higher odds of seeing a primary care physician compared with Hispanic mothers and those with no history of diabetes, respectively. Our analyses of a population of depressed mothers living in Los Angeles highlight the need for identification and treatment of racial minority and immigrant mothers.

EPIDEMIOLOGY OF NEW CASES OF HIV-1 INFECTION IN CHILDREN REFERRED TO THE METROPOLITAN PEDIATRIC HOSPITAL IN WASHINGTON, DC

Between 2000 and 2005, 84 HIV-infected children were referred to Children's National Medical Center; 28 were born to immigrant mothers, 89% of whom were of African descent. Rates of antiretroviral prophylaxis were low regardless of maternal origin. Nonimmigrant mothers (30.4%) used illicit drugs (P < 0.001), and 50% of immigrant mothers breast-fed their children (P < 0.001). These data can guide intervention strategies.

Immunization Coverage Among Young Children of Urban Immigrant Mothers: Findings from a Universal Health Care System

To investigate access to effective primary health care services in children of new immigrants to Canada by assessing immunization coverage at age 2. We used multiple linked administrative data sets to analyze primary health service use and immunizations of children born between July 1, 1997, and June 30, 1998, in Ontario, Canada. These children were linked via their mothers' records to a federal Landed Immigrant Database. We used logistic regression to assess the effect on up-to-date (UTD) status at age 2 of having an immigrant mother, controlling for patient and physician characteristics. We examined the relationship of region of origin, period of immigration, and refugee status on coverage. The study population comprised 98 123 children, of whom 66.5% had complete immunization coverage. Children of immigrant mothers were more likely to be UTD (adjusted odds ratio, 1.15; 95% confidence interval, 1.10, 1.19) than children born to nonimmigrant mothers. Within the group of children of immigrant mothers, those whose mothers were refugees had the lowest rates of coverage (66.6%), but when adjusting for maternal age, sex, neighborhood income quintile, and health services characteristics, region of origin was the most important predictor of coverage. Those from the region of Southeast and Northeast Asia were most likely to be UTD (odds ratio, 1.63; 95% confidence interval, 1.46, 1.81). Period of immigration was not associated with coverage. Contrary to expectations, immigrant mothers are accessing immunizations at least as well as nonimmigrants for their young children in Ontario. There is variation by region of origin and socioeconomic status. Universal access to care reduces disparities in immunization coverage, but overall rates are too low.

Breakfast eating and overweight in a pre-school population: is there a link?

To analyse the socio-economic factors related to breakfast eating, the association between breakfast eating and overweight, and to gain a more thorough understanding of the relationship between these two elements in a population-based cohort of 4.5-year-old children. We hypothesised that a relationship could be observed between breakfast skipping and overweight independently of socio-economic factors such as ethnicity, maternal education, single parenting and family income. A population-based study whereby standardised nutritional interviews were conducted with each child's parent. The children's height and weight were taken by a trained nutritionist and parents were asked about their child's breakfast eating. The analyses were performed using data from the Québec Longitudinal Study of Child Development (1998-2002), conducted by Santé Québec (Canada). Subjects were 1549 children between the ages of 44 and 56 months, with a mean age of 49 months. Almost a tenth (9.8%) of the children did not eat breakfast every day. A greater proportion of children with immigrant mothers (19.4% vs. 8.3% from non-immigrant mothers), with mothers with no high school diploma (17.5% vs. <10% for higher educated mothers) and from low-income families (15% for income of $39,999 or less vs. 5-10% for better income) did not eat breakfast every day. Not eating breakfast every day nearly doubled the odds (odds ratio=1.9, 95% confidence interval 1.2-3.2) of being overweight at 4.5 years when mother's immigrant status, household income and number of overweight/obese parents were part of the analysis. Although our results require replication before public policy changes can be advocated, encouraging breakfast consumption among pre-school children is probably warranted and targeting families of low socio-economic status could potentially help in the prevention of childhood obesity.