The impact of ethnicity and migration on pregnancy and birth outcomes: A
secondary analysis of the Born in Bradford cohort
Abstract
Objective: To investigate the relationship between maternal ethnicity
and migration status on perinatal outcomes. Design: Population-based
cohort Setting: Maternity department of a large hospital in Northern
England Population: Women delivering at Bradford Royal Infirmary between
March 2007 and December 2010 Methods: Impact of maternal migration
status and ethnicity were assessed using multiple logistic regression
for categorical outcomes and multiple linear regression for continuous
outcomes. Main outcome measures: Maternal and neonatal outcomes Results:
First-and-second-generation Pakistani migrants had higher odds of low
birthweight (aOR 1.63, CI 1.35-1.97 and aOR 2.01, CI 1.66-2.42
respectively) and gestational diabetes (aOR 2.68, CI 2.20-3.27 and
aOR1.79, CI 1.43-2.23) and lower odds of macrosomia (aOR 0.30, CI
0.24-0.37 and aOR 0.30, CI 0.24-0.39) compared to white British natives.
First-generation Pakistani migrants also had higher odds of stillbirth
(aOR 2.01, CI 1.00-4.01) and lower odds of preterm birth (aOR 0.80, CI
0.64-0.98) and APGAR score<7 at 1 minute (aOR 0.80, CI
0.68-0.94), which was not the case for other groups with either shared
ethnicity or migration status. Conclusion: This study highlights higher
odds of both low birthweight and lower odds of macrosomia among migrant
Pakistani mothers compared to native women, despite having higher rates
of gestational diabetes. Lower odds of preterm birth in first-generation
migrants compared to native and second-generation women is of interest,
however other poorer neonatal outcomes are concerning. The observed
intergenerational differences in particular merit further explorations.
Funding: The Burdett Trust for Nursing, grant number 472356. Key words:
Perinatal; Pregnancy; Ethnicity; Migration; Born in Bradford.