Increased risk of severe maternal morbidity (near-miss) among immigrant women in Sweden: a population register-based study
2013 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 120, no 13, 1605-1612 p.Article in journal (Refereed) Published
To determine if immigrant women from low-, middle- and high-income countries have an increased risk of severe maternal morbidity (near-miss) when they deliver in Sweden.
Population register-based study.
Nationwide study including all singleton deliveries (≥28 weeks of gestation) between 1998 and 2007.
Women with a near-miss event; all women with a singleton delivery ≥28 weeks of gestation during the same period acted as reference group.
Near-miss was defined by a combined clinical and management approach with use of International Classification of Diseases, 10th revision codes for severe maternal morbidity. A woman's country of origin was designated as low-, middle- or high-income according to the World Bank Classification of 2009. Unconditional logistic regression models were used in the analysis.
MAIN OUTCOME MEASURES:
Maternal near-miss frequencies per 1000 deliveries and odds ratios with 95% confidence intervals.
There were 914 474 deliveries during the study period and 2655 near-misses (2.9 per 1000 deliveries). In comparison to Swedish-born women, those from low-income countries had an increased risk of near-miss (odds ratio 2.3, 95% confidence interval 1.9-2.8) that was significant in all morbidity groups except for cardiovascular diseases and sepsis. Women from middle- and high-income countries showed no increased risk of near-miss.
Women from low-income countries have an increased risk of maternal near-miss morbidity compared with women born in Sweden. Although the rate is low it should alert healthcare providers.
Place, publisher, year, edition, pages
2013. Vol. 120, no 13, 1605-1612 p.
Immigration, maternal near-miss, severe maternal morbidity
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-208309DOI: 10.1111/1471-0528.12326PubMedID: 23786308OAI: oai:DiVA.org:uu-208309DiVA: diva2:651839