ROAM collaboration: see Appendix.
Disparities in pre-eclampsia and eclampsia among immigrant women giving birth in six industrialised countries
Article first published online: 24 APR 2014
© 2014 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 121, Issue 12, pages 1492–1500, November 2014
How to Cite
for the ROAM Collaboration. Disparities in pre-eclampsia and eclampsia among immigrant women giving birth in six industrialised countries. BJOG 2014;121:1492–1500., , , , , , , , , , , , ,
- Issue published online: 27 OCT 2014
- Article first published online: 24 APR 2014
- Manuscript Accepted: 13 FEB 2014
- Canadian Institutes of Health Research. Grant Number: MOP-123267
- health disparities;
- industrialised countries;
- pregnancy complications
To assess disparities in pre-eclampsia and eclampsia among immigrant women from various world regions giving birth in six industrialised countries.
Cross-country comparative study of linked population-based databases.
Provincial or regional obstetric delivery data from Australia, Canada, Spain and the USA and national data from Denmark and Sweden.
All immigrant and non-immigrant women delivering in the six industrialised countries within the most recent 10-year period available to each participating centre (1995–2010).
Data was collected using standardised definitions of the outcomes and maternal regions of birth. Pooled data were analysed with multilevel models. Within-country analyses used stratified logistic regression to obtain odds ratios (OR) with 95% confidence intervals (95% CI).
Main outcome measures
Pre-eclampsia, eclampsia and pre-eclampsia with prolonged hospitalisation (cases per 1000 deliveries).
There were 9 028 802 deliveries (3 031 399 to immigrant women). Compared with immigrants from Western Europe, immigrants from Sub-Saharan Africa and Latin America & the Caribbean were at higher risk of pre-eclampsia (OR: 1.72; 95% CI: 1.63, 1.80 and 1.63; 95% CI: 1.57, 1.69) and eclampsia (OR: 2.12; 95% CI: 1.61, 2.79 and 1.55; 95% CI: 1.26, 1. 91), respectively, after adjustment for parity, maternal age and destination country. Compared with native-born women, European and East Asian immigrants were at lower risk in most industrialised countries. Spain exhibited the largest disparities and Australia the smallest.
Immigrant women from Sub-Saharan Africa and Latin America & the Caribbean require increased surveillance due to a consistently high risk of pre-eclampsia and eclampsia.