Preterm delivery risk in migrants in Italy: an observational prospective study

J Travel Med. 2008 Jul-Aug;15(4):243-7. doi: 10.1111/j.1708-8305.2008.00215.x.

Abstract

Background: Various studies have ascertained different birth outcomes between resident and migrant populations in western countries. Considering preterm delivery (<37 complete weeks of gestation) as a perinatal risk condition, we assessed its rate in migrant and native Italian women who delivered in the main public hospital in Brescia (Italy).

Methods: All migrant puerperas and a random sample of native puerperas hospitalized during the period February to May 2005 were included in the study after informed consent and filled in a self-administered multilanguage questionnaire enquiring about sociodemographic and obstetric data. Additional information including last menstrual period was obtained from personal obstetric records.

Results: As many as 471 puerperas entered the study: 366 Italian and 105 migrant women coming from eastern Europe (41.9%), Asia (20%), South America (10.5%), and Africa (27.6%). Of the migrant population, 67 of 105 (63.8%) were at their first delivery in Italy (median interval from arrival: 3.8 y). Gestational age at delivery was assessed for 456 of 471 women (103 migrants and 353 Italians). A total of 36 (7.9%) preterm deliveries were registered: 22 (6.2%) in Italian and 14 (13.6%) in migrant puerperas (p value = 0.015). The highest preterm delivery rate was observed in African women (20.7%), while women from eastern Europe had a similar rate to Italians. In univariate analysis, factors associated to preterm delivery were parity and length of permanence in Italy. We could not demonstrate any correlation with smoking or with a delayed access to antenatal care (first obstetric evaluation after 12 complete weeks of gestation). In multivariate analysis, African origin was the only independent risk factor for preterm delivery [odds ratio (OR) = 3.54; p = 0.018].

Conclusions: In our setting, preterm delivery occurred more frequently in migrant women, particularly of African origin, and it is not associated to delayed access to antenatal care.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Africa / ethnology
  • Asia / ethnology
  • Cohort Studies
  • Confidence Intervals
  • Emigration and Immigration / statistics & numerical data*
  • Europe / ethnology
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Italy / epidemiology
  • Life Style
  • Obstetric Labor, Premature / epidemiology*
  • Obstetric Labor, Premature / ethnology
  • Odds Ratio
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Pregnancy Outcome / ethnology
  • Prenatal Care / statistics & numerical data
  • Prospective Studies
  • Regression Analysis
  • Risk Factors
  • Travel
  • Women's Health / ethnology*