Caesarean section and neonatal outcomes among women of migrant origin in Finland

Abstract

Abstract Background In Finland, limited information is available on neonatal disparities among migrant origin women. We investigated differences in caesarean section and neonatal outcomes between migrant and Finnish origin women in Finland. Methods National data from the Medical Birth Register of Finland included information on the most recent singleton birth of all women (n = 382 233) between January 2004 and December 2014. We categorized women into nine regional categories based on their country of origin by linked population data from Statistics Finland. Women with Finnish origin were used as a reference group. Our main statistical method was logistic regression analyses adjusted for age, socio-economic status, pre-pregnancy body mass index, gestational age, parity, marital status, smoking during pregnancy, and ponderal index. Results Compared with Finnish women, Sub-Saharan African women had higher odds for caesarean sections OR 2.14 (95% CI 1.96, 2.33), preterm births OR 1.22 (95% CI 1.0, 1.43), low 5 minutes Apgar score OR 3.73 (95% CI 3.09, 4.49), and intensive care unit care OR 1.39 (95% CI 1.24, 1.56) for newborns. South Asian and East Asian women were at increased risk for caesarean births OR 1.52 (95% CI 1.36, 1.71) and OR 1.19 (95% CI 1.10, 1.28) respectively, preterm birth OR 1.46 (95% CI 1.20, 1.77), and OR 1.28 (95% CI 1.13, 1.46) and low 5 minutes Apgar score OR 2.06 (95% CI 1.55, 2.76), and OR 1.36 (95% CI 1.11, 1.67) compared with Finnish women. Middle Eastern and Latin America/Caribbean women had higher odds for caesarean births OR 1.13 (95% CI 1.02, 1.24), and OR 1.66 (95% CI 1.39, 1.97) respectively and low 5 minutes Apgar score OR 1.69 (95% CI 1.34, 2.14) and OR 2.12, (95% CI 1.37, 3.26) compared with Finnish women. Conclusions Groups of women with higher risk for caesarean section and poor neonatal outcomes were identified and they may need more attention in maternal and child health services. Key messages Women from Sub-Saharan African, East Asian and South Asian origin had an elevated risk for most of the poor obstetric outcomes compared with Finnish women. Women from East Asian and Russian/former USSR countries had lower risk for caesarean section and newborns care in intensive care unit compared with Finnish women.