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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.

Author information

1
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada.
2
Department of Pediatrics, McGill University, Montreal, Canada.
3
Health Analysis Division, Statistics Canada, Ottawa, Canada.
4
Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada.
5
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.

Abstract

Background:

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

Methods:

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.

Results:

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.

Conclusions:

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.

PMID:
30715416
DOI:
10.1093/pubmed/fdz006

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