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J Public Health (Oxf). 2019 Jan 31. doi: 10.1093/pubmed/fdz006. [Epub ahead of print]

Perinatal health among foreign versus native-born mothers in Canada: variations across outcomes and cohorts.

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Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada.
Department of Pediatrics, McGill University, Montreal, Canada.
Health Analysis Division, Statistics Canada, Ottawa, Canada.
Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.



To examine perinatal health differences between foreign-born and native-born mothers in Canada across multiple outcomes and two cohorts 10 years apart.


Using 94 896 and 131 271 births in the 1996 and 2006 Canadian Census-Birth Cohort, respectively, we estimated risk ratios and risk differences of preterm birth (PTB), small-for-gestational age (SGA), large-for-gestational age (LGA), stillbirth and infant mortality between foreign-born and Canadian-born mothers.


In the 1996 cohort, we observed no important differences in adverse outcomes between foreign-born and native-born mothers. In the 2006 cohort, however, foreign-born mothers had lower risks of PTB, LGA, stillbirth, and infant mortality and a higher risk of SGA on both the relative and absolute scales. Lowered risk of PTB among foreign-born mothers in the 2006 cohort was also observed within Caucasian, East Asian, Southeast Asian and South Asian mothers. Favourable outcomes associated with foreign-born status in the 2006 cohort were negatively graded by duration of residence in Canada among immigrant mothers.


Differences in perinatal health by maternal foreign-born status varied across cohorts and a more pronounced 'healthy migrant' effect was observed among more recent migrants. The native-born mothers' perinatal health over time and a more restrictive/selective immigration policy in recent years would explain our results.


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