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The impact of migration background on maternal near miss

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

(1) To evaluate the association between immigration background and the occurrence of maternal near miss (MNM). (2) To identify medical co-factors, health-care utilization, and health-care disparities as explanations of a possibly higher risk of MNM among immigrants.

Methods

We compared perinatal outcomes between immigrant women (first- or second-generation) versus non-immigrant women, delivering at three maternity hospitals in Berlin, Germany, 2011–2012. Near-miss events were defined as: HELLP syndrome, eclampsia, the occurrence or threat of uterine rupture, postpartum hemorrhage (PPH) > 1000 ml, sepsis, peripartal hysterectomy, cardiovascular complications, lung embolism. Logistic regression analyses were performed to determine the associations of immigration status, acculturation, and language competency with near-miss events, and of near-miss events with the perinatal outcomes.

Results

The databank included 2647 first-generation immigrants, 889 second-generation immigrants, and 3231 women without an immigration background (total N = 6767). Near-miss events occurred in 141 women. The likelihood of near-miss events was lower among multiparous women (OR 0.6; 95% CI 0.42–0.87; p = 0.01). No other factors had a statistically significant influence. Near-miss events are associated with an elevated likelihood for an unfavorable perinatal condition: the ORs ranged from 2.15 for an arterial umbilical cord pH value < 7.1–2.47 for premature delivery.

Conclusions

Immigration status does not change the risk of near-miss events. Besides parity, no medical or socio-demographic factors were identified that were associated with an elevated likelihood for the occurrence of severe peripartal complications.

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Acknowledgements

We would like to thank Michael Hanna, PhD (Mercury Medical Research and Writing), for translating the manuscript from German to English.

Funding

This study was supported by Deutsche Forschungsgemeinschaft (Grant No. FKZ: DA 1199/2-1).

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Authors and Affiliations

  1. Department of Gynecology, Campus Virchow-Klinikum, Klinik für Gynäkologie, Charité University Hospital, Augustenburger Platz 1, 13353, Berlin, Germany

    Matthias David

  2. Department of Epidemiology and International Public Health; Bielefeld School of Public Health, Bielefeld University, Bielefeld, Germany

    Oliver Razum & Jürgen Breckenkamp

  3. Department of Obstetrics, Virchow and Mitte Campuses, Charité University Hospital, Berlin, Germany

    Wolfgang Henrich

  4. Department of Obstetrics, Vivantes Hospital Neukölln, Berlin, Germany

    Babett Ramsauer & Dietmar Schlembach

Authors
  1. Matthias David
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  2. Oliver Razum
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  3. Wolfgang Henrich
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  4. Babett Ramsauer
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  6. Jürgen Breckenkamp
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Correspondence to Matthias David.

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David, M., Razum, O., Henrich, W. et al. The impact of migration background on maternal near miss. Arch Gynecol Obstet 300, 285–292 (2019). https://doi.org/10.1007/s00404-019-05179-9

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  • DOI: https://doi.org/10.1007/s00404-019-05179-9

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