Disparities in pre-eclampsia and eclampsia among immigrant women giving birth in six industrialised countries

TY - JOUR

T1 - Disparities in pre-eclampsia and eclampsia among immigrant women giving birth in six industrialised countries

AU - Urquia, Ml

AU - Glazier, Rh

AU - Gagnon, Aj

AU - Mortensen, Laust Hvas

AU - Andersen, Anne-Marie Nybo

AU - Janevic, T

AU - Guendelman, S

AU - Thornton, D

AU - Bolumar, F

AU - Río Sánchez, I

AU - Small, R

AU - Davey, M-A

AU - Hjern, A

AU - the ROAM Collaboration

N1 - © 2014 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - OBJECTIVE: To assess disparities in preeclampsia and eclampsia among immigrant women from various world regions giving birth in six industrialised countries.DESIGN: Cross-country comparative study of linked population-based databases.SETTING: Provincial or regional obstetric delivery data from Australia, Canada, Spain and the USA and national data from Denmark and Sweden.POPULATION: All immigrant and non-immigrant women delivering in the six industrialised countries within the most recent 10-year period available to each participating centre (1995-2010).METHODS: Data was collected using standardised definitions of the outcomes and maternal regions of birth. Pooled data were analysed with multilevel models. Within-country analyses used stratified logistic regression to obtain odds ratios (OR) with 95% confidence intervals (95% CI).MAIN OUTCOME MEASURES: Preeclampsia, eclampsia and preeclampsia with prolonged hospitalisation (cases per 1000 deliveries).RESULTS: There were 9 028 802 deliveries (3 031 399 to immigrant women). Compared with immigrants from Western Europe, immigrants from Sub-Saharan Africa and Latin America & the Caribbean were at higher risk of preeclampsia (OR: 1.72; 95% CI: 1.63, 1.80 and 1.63; 95% CI: 1.57, 1.69) and eclampsia (OR: 2.12; 95% CI: 1.61, 2.79 and 1.55; 95% CI: 1.26, 1. 91), respectively, after adjustment for parity, maternal age and destination country. Compared with native-born women, European and East Asian immigrants were at lower risk in most industrialised countries. Spain exhibited the largest disparities and Australia the smallest.CONCLUSION: Immigrant women from Sub-Saharan Africa and Latin America & the Caribbean require increased surveillance due to a consistently high risk of preeclampsia and eclampsia.

AB - OBJECTIVE: To assess disparities in preeclampsia and eclampsia among immigrant women from various world regions giving birth in six industrialised countries.DESIGN: Cross-country comparative study of linked population-based databases.SETTING: Provincial or regional obstetric delivery data from Australia, Canada, Spain and the USA and national data from Denmark and Sweden.POPULATION: All immigrant and non-immigrant women delivering in the six industrialised countries within the most recent 10-year period available to each participating centre (1995-2010).METHODS: Data was collected using standardised definitions of the outcomes and maternal regions of birth. Pooled data were analysed with multilevel models. Within-country analyses used stratified logistic regression to obtain odds ratios (OR) with 95% confidence intervals (95% CI).MAIN OUTCOME MEASURES: Preeclampsia, eclampsia and preeclampsia with prolonged hospitalisation (cases per 1000 deliveries).RESULTS: There were 9 028 802 deliveries (3 031 399 to immigrant women). Compared with immigrants from Western Europe, immigrants from Sub-Saharan Africa and Latin America & the Caribbean were at higher risk of preeclampsia (OR: 1.72; 95% CI: 1.63, 1.80 and 1.63; 95% CI: 1.57, 1.69) and eclampsia (OR: 2.12; 95% CI: 1.61, 2.79 and 1.55; 95% CI: 1.26, 1. 91), respectively, after adjustment for parity, maternal age and destination country. Compared with native-born women, European and East Asian immigrants were at lower risk in most industrialised countries. Spain exhibited the largest disparities and Australia the smallest.CONCLUSION: Immigrant women from Sub-Saharan Africa and Latin America & the Caribbean require increased surveillance due to a consistently high risk of preeclampsia and eclampsia.

U2 - 10.1111/1471-0528.12758

DO - 10.1111/1471-0528.12758

M3 - Journal article

C2 - 24758368

SN - 0140-7686

VL - 121

SP - 1492

EP - 1500

JO - The Journal of obstetrics and gynaecology of the British Commonwealth

JF - The Journal of obstetrics and gynaecology of the British Commonwealth

IS - 12

ER -