Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis

Behboudi-Gandevani, Samira; Bidhendi-Yarandi, Razieh; Panahi, Mohammad Hossein; Mardani, Abbas; Paal, Piret; Prinds, Christina; Vaismoradi, Mojtaba

doi:10.5334/aogh.3591

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Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis

Samira Behboudi-Gandevani, Razieh Bidhendi-Yarandi, Mohammad Hossein Panahi, Abbas Mardani, Piret Paal, Christina Prinds, Mojtaba Vaismoradi

Annals of Global Health, Volume: 88, Issue: 1, Start page: 44

Swansea University Author: Mojtaba Vaismoradi

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DOI (Published version): 10.5334/aogh.3591

Abstract

Background: Disparities in health outcomes between immigrant and native-origin populations, particularly pregnant women, pose significant challenges to healthcare systems. The aim of this systematic-review and meta-analysis was to investigate the risk of adverse pregnancy outcomes among immigrant-wo...

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Published in:	Annals of Global Health
ISSN:	2214-9996
Published:	Ubiquity Press, Ltd. 2022
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fullrecord	<?xml version="1.0"?><rfc1807><datestamp>2022-07-14T12:37:04.7466121</datestamp><bib-version>v2</bib-version><id>60336</id><entry>2022-06-29</entry><title>Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis</title><swanseaauthors><author><sid>b865b33654e99f5cbccdb11350f7b069</sid><firstname>Mojtaba</firstname><surname>Vaismoradi</surname><name>Mojtaba Vaismoradi</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2022-06-29</date><deptcode>FGMHL</deptcode><abstract>Background: Disparities in health outcomes between immigrant and native-origin populations, particularly pregnant women, pose significant challenges to healthcare systems. The aim of this systematic-review and meta-analysis was to investigate the risk of adverse pregnancy outcomes among immigrant-women compared to native-origin women in the host country.Methods: PubMed (including MEDLINE), Scopus, and Web of Science were searched to retrieve studies published in English language up to September 2020. All observational studies examining the prevalence of at least one of the short-term single pregnancy outcomes for immigrants who crossed international borders compared to native-origin pregnant population were included. The meta-prop method was used for the pooled-estimation of adverse pregnancy-outcomes’ prevalence. For pool-effect estimates, the association between the immigration-status and outcomes of interest, the random-effects model was applied using the model described by DerSimonian and Laird. I2 statistic was used to assess heterogeneity. The publication bias was assessed using the Harbord-test. Meta-regression was performed to explore the effect of geographical region as the heterogeneity source.Findings: This review involved 11 320 674 pregnant women with an immigration-background and 56 102 698 pregnant women as the native-origin population. The risk of emergency cesarean section (Pooled-OR = 1.1, 95%CI = 1.0–1.2), shoulder dystocia (Pooled-OR = 1.1, 95%CI = 1.0–1.3), gestational diabetes mellites (Pooled-OR = 1.4, 95%CI = 1.2–1.6), small for gestational age (Pooled-OR=1.3, 95%CI = 1.1–0.4), 5-min Apgar less than 7 (Pooled-OR = 1.2, 95%CI = 1.0–1.3) and oligohydramnios (Pooled-OR = 1.8, 95%CI = 1.0–3.3) in the immigrant women were significantly higher than those with the native origin background. The immigrant women had a lower risk of labor induction (Pooled-OR = 0.8, 95%CI = 0.7–0.8), pregnancy induced hypertension (Pooled-OR = 0.6, 95%CI = 0.5–0.7) preeclampsia (Pooled-OR = 0.7, 95%CI = 0.6–0.8), macrosomia (Pooled-OR = 0.8, 95%CI = 0.7–0.9) and large for gestational age (Pooled-OR = 0.8, 95%CI = 0.7–0.8). Also, the risk of total and primary cesarean section, instrumental-delivery, preterm-birth, and birth-trauma were similar in both groups. According to meta-regression analyses, the reported ORs were not influenced by the country of origin.Conclusion: The relationship between the immigration status and adverse perinatal outcomes indicated a heterogenous pattern, but the immigrant women were at an increased risk of some important adverse pregnancy outcomes. Population-based studies with a focus on the various aspects of this phenomena are required to explain the source of these heterogenicities.</abstract><type>Journal Article</type><journal>Annals of Global Health</journal><volume>88</volume><journalNumber>1</journalNumber><paginationStart>44</paginationStart><paginationEnd/><publisher>Ubiquity Press, Ltd.</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2214-9996</issnElectronic><keywords>Adverse Pregnancy Outcomes; International immigration; Meta-analysis</keywords><publishedDay>28</publishedDay><publishedMonth>6</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-06-28</publishedDate><doi>10.5334/aogh.3591</doi><url/><notes/><college>COLLEGE NANME</college><department>Medicine, Health and Life Science - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGMHL</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>Nord University, Bodø, Norway covered APC to this article</funders><lastEdited>2022-07-14T12:37:04.7466121</lastEdited><Created>2022-06-29T08:10:55.8788855</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care - Nursing</level></path><authors><author><firstname>Samira</firstname><surname>Behboudi-Gandevani</surname><order>1</order></author><author><firstname>Razieh</firstname><surname>Bidhendi-Yarandi</surname><order>2</order></author><author><firstname>Mohammad Hossein</firstname><surname>Panahi</surname><order>3</order></author><author><firstname>Abbas</firstname><surname>Mardani</surname><order>4</order></author><author><firstname>Piret</firstname><surname>Paal</surname><order>5</order></author><author><firstname>Christina</firstname><surname>Prinds</surname><order>6</order></author><author><firstname>Mojtaba</firstname><surname>Vaismoradi</surname><order>7</order></author></authors><documents><document><filename>60336__24410__b01428252bcc43c9a8256de23815e65b.pdf</filename><originalFilename>3591-15590-1-PB.pdf</originalFilename><uploaded>2022-06-29T08:16:11.1498144</uploaded><type>Output</type><contentLength>8758161</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© 2022 The Author(s). 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spelling	2022-07-14T12:37:04.7466121 v2 60336 2022-06-29 Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis b865b33654e99f5cbccdb11350f7b069 Mojtaba Vaismoradi Mojtaba Vaismoradi true false 2022-06-29 FGMHL Background: Disparities in health outcomes between immigrant and native-origin populations, particularly pregnant women, pose significant challenges to healthcare systems. The aim of this systematic-review and meta-analysis was to investigate the risk of adverse pregnancy outcomes among immigrant-women compared to native-origin women in the host country.Methods: PubMed (including MEDLINE), Scopus, and Web of Science were searched to retrieve studies published in English language up to September 2020. All observational studies examining the prevalence of at least one of the short-term single pregnancy outcomes for immigrants who crossed international borders compared to native-origin pregnant population were included. The meta-prop method was used for the pooled-estimation of adverse pregnancy-outcomes’ prevalence. For pool-effect estimates, the association between the immigration-status and outcomes of interest, the random-effects model was applied using the model described by DerSimonian and Laird. I2 statistic was used to assess heterogeneity. The publication bias was assessed using the Harbord-test. Meta-regression was performed to explore the effect of geographical region as the heterogeneity source.Findings: This review involved 11 320 674 pregnant women with an immigration-background and 56 102 698 pregnant women as the native-origin population. The risk of emergency cesarean section (Pooled-OR = 1.1, 95%CI = 1.0–1.2), shoulder dystocia (Pooled-OR = 1.1, 95%CI = 1.0–1.3), gestational diabetes mellites (Pooled-OR = 1.4, 95%CI = 1.2–1.6), small for gestational age (Pooled-OR=1.3, 95%CI = 1.1–0.4), 5-min Apgar less than 7 (Pooled-OR = 1.2, 95%CI = 1.0–1.3) and oligohydramnios (Pooled-OR = 1.8, 95%CI = 1.0–3.3) in the immigrant women were significantly higher than those with the native origin background. The immigrant women had a lower risk of labor induction (Pooled-OR = 0.8, 95%CI = 0.7–0.8), pregnancy induced hypertension (Pooled-OR = 0.6, 95%CI = 0.5–0.7) preeclampsia (Pooled-OR = 0.7, 95%CI = 0.6–0.8), macrosomia (Pooled-OR = 0.8, 95%CI = 0.7–0.9) and large for gestational age (Pooled-OR = 0.8, 95%CI = 0.7–0.8). Also, the risk of total and primary cesarean section, instrumental-delivery, preterm-birth, and birth-trauma were similar in both groups. According to meta-regression analyses, the reported ORs were not influenced by the country of origin.Conclusion: The relationship between the immigration status and adverse perinatal outcomes indicated a heterogenous pattern, but the immigrant women were at an increased risk of some important adverse pregnancy outcomes. Population-based studies with a focus on the various aspects of this phenomena are required to explain the source of these heterogenicities. Journal Article Annals of Global Health 88 1 44 Ubiquity Press, Ltd. 2214-9996 Adverse Pregnancy Outcomes; International immigration; Meta-analysis 28 6 2022 2022-06-28 10.5334/aogh.3591 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University Another institution paid the OA fee Nord University, Bodø, Norway covered APC to this article 2022-07-14T12:37:04.7466121 2022-06-29T08:10:55.8788855 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing Samira Behboudi-Gandevani 1 Razieh Bidhendi-Yarandi 2 Mohammad Hossein Panahi 3 Abbas Mardani 4 Piret Paal 5 Christina Prinds 6 Mojtaba Vaismoradi 7 60336__24410__b01428252bcc43c9a8256de23815e65b.pdf 3591-15590-1-PB.pdf 2022-06-29T08:16:11.1498144 Output 8758161 application/pdf Version of Record true © 2022 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0) true eng http://creativecommons.org/licenses/by/4.0/
title	Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis
spellingShingle	Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis Mojtaba Vaismoradi
title_short	Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis
title_full	Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis
title_fullStr	Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis
title_full_unstemmed	Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis
title_sort	Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis
author_id_str_mv	b865b33654e99f5cbccdb11350f7b069
author_id_fullname_str_mv	b865b33654e99f5cbccdb11350f7b069_***_Mojtaba Vaismoradi
author	Mojtaba Vaismoradi
author2	Samira Behboudi-Gandevani Razieh Bidhendi-Yarandi Mohammad Hossein Panahi Abbas Mardani Piret Paal Christina Prinds Mojtaba Vaismoradi
format	Journal article
container_title	Annals of Global Health
container_volume	88
container_issue	1
container_start_page	44
publishDate	2022
institution	Swansea University
issn	2214-9996
doi_str_mv	10.5334/aogh.3591
publisher	Ubiquity Press, Ltd.
college_str	Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id	facultyofmedicinehealthandlifesciences
hierarchy_top_title	Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id	facultyofmedicinehealthandlifesciences
hierarchy_parent_title	Faculty of Medicine, Health and Life Sciences
department_str	School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
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description	Background: Disparities in health outcomes between immigrant and native-origin populations, particularly pregnant women, pose significant challenges to healthcare systems. The aim of this systematic-review and meta-analysis was to investigate the risk of adverse pregnancy outcomes among immigrant-women compared to native-origin women in the host country.Methods: PubMed (including MEDLINE), Scopus, and Web of Science were searched to retrieve studies published in English language up to September 2020. All observational studies examining the prevalence of at least one of the short-term single pregnancy outcomes for immigrants who crossed international borders compared to native-origin pregnant population were included. The meta-prop method was used for the pooled-estimation of adverse pregnancy-outcomes’ prevalence. For pool-effect estimates, the association between the immigration-status and outcomes of interest, the random-effects model was applied using the model described by DerSimonian and Laird. I2 statistic was used to assess heterogeneity. The publication bias was assessed using the Harbord-test. Meta-regression was performed to explore the effect of geographical region as the heterogeneity source.Findings: This review involved 11 320 674 pregnant women with an immigration-background and 56 102 698 pregnant women as the native-origin population. The risk of emergency cesarean section (Pooled-OR = 1.1, 95%CI = 1.0–1.2), shoulder dystocia (Pooled-OR = 1.1, 95%CI = 1.0–1.3), gestational diabetes mellites (Pooled-OR = 1.4, 95%CI = 1.2–1.6), small for gestational age (Pooled-OR=1.3, 95%CI = 1.1–0.4), 5-min Apgar less than 7 (Pooled-OR = 1.2, 95%CI = 1.0–1.3) and oligohydramnios (Pooled-OR = 1.8, 95%CI = 1.0–3.3) in the immigrant women were significantly higher than those with the native origin background. The immigrant women had a lower risk of labor induction (Pooled-OR = 0.8, 95%CI = 0.7–0.8), pregnancy induced hypertension (Pooled-OR = 0.6, 95%CI = 0.5–0.7) preeclampsia (Pooled-OR = 0.7, 95%CI = 0.6–0.8), macrosomia (Pooled-OR = 0.8, 95%CI = 0.7–0.9) and large for gestational age (Pooled-OR = 0.8, 95%CI = 0.7–0.8). Also, the risk of total and primary cesarean section, instrumental-delivery, preterm-birth, and birth-trauma were similar in both groups. According to meta-regression analyses, the reported ORs were not influenced by the country of origin.Conclusion: The relationship between the immigration status and adverse perinatal outcomes indicated a heterogenous pattern, but the immigrant women were at an increased risk of some important adverse pregnancy outcomes. Population-based studies with a focus on the various aspects of this phenomena are required to explain the source of these heterogenicities.
published_date	2022-06-28T04:18:21Z
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Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis

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