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Trends in maternal mortality in Switzerland among Swiss and foreign nationals, 1969–2006

  • Original Article
  • Published:
International Journal of Public Health

Abstract

Objectives

To test whether maternal mortality was higher among immigrant women than Swiss women.

Methods

All maternal deaths and live births in Switzerland from 1969 to 2006 from official vital statistics were considered. We calculated maternal mortality ratios (MMRs) in four time intervals (1969–1979, 1980–1989, 1990–1999, 2000–2006) for both Swiss and immigrant women overall, and for Italian, Spanish and Turkish women. We also computed the odds ratios and 95% confidence intervals of maternal mortality over the four time periods, considering maternal deaths as cases, and live births as controls.

Results

From 1969 to 2006 there were 279 maternal deaths, 204 of Swiss women and 75 of immigrant women. Women’s age, marital status and cause of death were similar in the two groups. For immigrant women, the crude odds ratio of a pregnancy ending with maternal death, not homogeneous across the four periods, was 4.38 (95% CI 1.88–10.55) in 2000–2006.

Conclusions

Immigrant women have a higher risk of maternal mortality than Swiss women. A closer scrutiny of risk factors and quality of care is necessary to identify opportunities for prevention.

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References

  • Bischoff A, Hudelson P (2010) Access to healthcare interpreter services: where are we and where do we need to go? Int J Environ Res Public Health 7:2838–2844

    Article  PubMed  Google Scholar 

  • Bollini P, Wanner P (2006) Santé reproductive des collectivités migrantes. Disparités de risques et possibilités d’intervention. Office fédéral de la Santé Publique, Berne

    Google Scholar 

  • Bollini P, Stotzer U, Wanner P (2007) Pregnancy outcomes and migration: a focus group study. lnt J Public Health 52:78–86

    Article  Google Scholar 

  • Bragg R (2008) Maternal deaths and vulnerable migrants. Lancet 371:879–881

    Article  PubMed  Google Scholar 

  • Calderón MAK, Bustamante Montes P, Campuzano Gonzales M, Pliego AC (2007) Social aspects of maternal mortality: a case study of the State of Mexico. Soc Med 2:186–191

    Google Scholar 

  • Confidential Enquiry into Maternal and Child Health (2007) Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer 2003–2005. CEMACH, London

  • Corporation STATA (2005) Intercooled STATA 9.0. Stata Corporation College Station, Texas

    Google Scholar 

  • Degrate A, Testa-Mader A, Clerici N (1999) Mortality in the Swiss and foreign immigrants in the Canton of Ticino. Epidemiol Prev 23:84–89

    PubMed  CAS  Google Scholar 

  • Delvaux T, Buekens P, Godin I, Boutsen M, The Study Group on Barriers, Incentives to Prenatal Care in Europe (2001) Barriers to prenatal care in Europe. Am J Prev Med 21:52–59

    Article  PubMed  CAS  Google Scholar 

  • Deneux-Tharaux C, Philibert M, Bouvier-Colle M (2009) Excess maternal mortality among foreign women in France and quality of obstetric care: a national study 1996–2001. Bulletin Epidémiologique Hebdomadaire, INVS 77–80

  • Euro-Peristat Project (2008) European Perinatal Health Report

  • Haelterman E, Qvist R, Barlow P, Alexander S (2003) Social deprivation and poor access to care as risk factors for severe pre-eclampsia. Eur J Obstet Gynaecol Reprod Biol 111:25–32

    Article  Google Scholar 

  • Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, Lopez AD, Lozano R, Murray CJL (2010) Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet 375:1609–1623

    Article  PubMed  Google Scholar 

  • Hoyert DL (2007) Maternal mortality and related concepts. National Center for Health Statistics. Vital Health Stat 3(33):1–13

    Google Scholar 

  • Ibison JM, Swerdlow AJ, Head JA, Marmot M (1996) Maternal mortality in England and Wales 1970–1985: an analysis by country of birth. Br J Obstet Gynaecol 103:973–980

    Article  PubMed  CAS  Google Scholar 

  • Larsen TB, Johnsen SP, Møller CI (2005) A review of medical records and discharge summary data found moderate to high predictive values of discharge diagnoses of venous thromboembolism during pregnancy and postpartum. J Clin Epidemiol 58:316–319

    Article  PubMed  Google Scholar 

  • Lehmann P, Mamboury C, Minder CE (1990) Health and social inequities in Switzerland. Soc Sci Med 31:369–386

    Article  PubMed  CAS  Google Scholar 

  • Meili G, Huch R, Huch A, Zimmermann R (2003) Mütterliche Mortalität in der Schweiz 1985–1994. Gynäkol Geburtshilfliche Rundsch 43:158–165

    Article  PubMed  Google Scholar 

  • Nazroo JY (1997) The health of Britain’s ethnic minorities: findings from a national survey. Policy Studies Institute, London

    Google Scholar 

  • Office fédéral de la Santé Publique (2008) Migration et santé. Résumé de la stratégie fédérale phase II (2008 à 2013). Office fédéral de la Santé Publique, Berne

  • Office fédéral de la Statistique (2004) Migration et intégration. Populations étrangères en Suisse. Office fédéral de la Statistique, Neuchâtel

  • Philibert M, Deneux-Tharaux C, Bouvier-Colle MH (2009) Can excess maternal mortality among women of foreign nationality be explained by suboptimal obstetric care? Br J Obstet Gynaecol 115:1411–1418

    Google Scholar 

  • Razum O, Jahn A, Blettner M, Reitmaier P (1999) Trends in maternal mortality ratio among women of German and non-German nationality in West Germany, 1980–1996. Int J Epidemiol 28:919–924

    Article  PubMed  CAS  Google Scholar 

  • Salanave B, Bouvier-Colle MH, Varnoux N, Alexander S, McFarlane A, The MOMS Group (1999) Classification differences and maternal mortality: a European study. Int J Epidemiol 28:64–69

    Article  PubMed  CAS  Google Scholar 

  • Schlesselman JJ, Stolley PD (1982) Case–control studies: design, conduct, analysis. Oxford University Press, New York

    Google Scholar 

  • Stirbu I, Kunst AE, Bos V, Mackenbach JP (2006) Differences in avoidable mortality between migrants and the native Dutch in The Netherlands. BMC Public Health 6:78

    Article  PubMed  CAS  Google Scholar 

  • Turner LA, Cyr M, Kinch RAH, Liston R, Kramer MS, Fair M (2002) Under-reporting of maternal mortality in Canada: a question of definition. Chronic Dis Can 23:1–15

    Google Scholar 

  • Van Roosmalen J, Schuitemaker NWE, Brand R, Van Dongen PWJ, Gravenhorst JB (2002) Substandard care in immigrant versus indigenous maternal deaths in The Netherlands. Br J Obstet Gynaecol 109:212–213

    Google Scholar 

  • Wanner P, Piguet E, Hayford SR (2002) The practice of naturalization in Switzerland: a statistical overview. Population (English Edition, 2002) 57(6):917–925

    Google Scholar 

  • Wolff H, Epiney M, Lourenco AP, Costanza MC, Delieutraz-Marchand J, Andreoli N, Dubuisson JB, Gaspoz JM, Irion O (2008) Undocumented migrants lack access to pregnancy care and prevention. BMC Public Health 8:93–103

    Article  PubMed  Google Scholar 

  • World Health Organization (1969) International classification of diseases and related health problems, 8th revision. World Health Organization, Geneva

    Google Scholar 

  • World Health Organization (1993) International classification of diseases and related health problems, 10th revision. World Health Organization, Geneva

    Google Scholar 

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Acknowledgments

We would like to thank two unknown referees for their thoughtful suggestions, the Federal Office of Statistics for making available records of maternal mortality and live births, and Elisabeth von Gunten for assistance with ICD-8 and ICD-10 coding of maternal mortality.

Conflict of interest

The authors declare that they have no competing interests.

Author information

Authors and Affiliations

  1. Services for Medical Research forMed, Evolène, Switzerland

    Paola Bollini & Sandro Pampallona

  2. LaboDémo, University of Geneva, Geneva, Switzerland

    Philippe Wanner

Authors
  1. Paola Bollini
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  2. Philippe Wanner
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  3. Sandro Pampallona
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Corresponding author

Correspondence to Paola Bollini.

Additional information

This paper belongs to the special issue “Migrants and ethnic minorities in Europe: new challenges for public health research and practice”.

Appendix

Appendix

List of countries of origin with at least one maternal death and number of maternal deaths, Switzerland 1969–2006.

Country

No. of maternal deaths

Austria

1

Bosnia–Herzegovina

1

China

1

Congo–Kinshasa

1

France

4

Germany

1

Guinea–Bissau

1

Italy

30

Macedonia

1

Malaysia

1

Portugal

3

South Africa

1

Spain

11

Sri Lanka

1

Thailand

1

Turkey

6

United Kingdom

1

Yougoslavia

1

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Bollini, P., Wanner, P. & Pampallona, S. Trends in maternal mortality in Switzerland among Swiss and foreign nationals, 1969–2006. Int J Public Health 56, 515–521 (2011). https://doi.org/10.1007/s00038-010-0213-9

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  • DOI: https://doi.org/10.1007/s00038-010-0213-9

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