title: Recent immigration and adverse pregnancy outcomes in an urban setting in Spain.
abstract: To describe social and economic inequalities in non-fatal pregnancy outcomes (low birth weight, preterm birth and small for gestational age births) in the neighbourhoods of the city of Barcelona (Spain), according to maternal age and maternal country of origin, between 1991 and 2005. A cross-sectional ecological study was carried out using the 38 neighbourhoods of Barcelona as the unit of analysis. The study population comprises the 192,921 live births to resident women aged 12-49 residing from 1991 to 2005. Information was gathered from births registry. Prevalence of low birth-weight, preterm birth and small for gestational age, was calculated for each of the 38 neighbourhoods of mothers' residence, stratifying results by maternal age and country of origin. The indicator of neighbourhood socio-economic level was the unemployment rate. Quartile maps along with Spearman correlation coefficients and linear regression were performed between indicators. The present study reports socio-economic inequalities in pregnancy outcomes among neighbourhoods in Barcelona (Spain): the more disadvantaged neighbourhoods have worse pregnancy outcomes (low birth weight, preterm birth and small for gestational age births) in all women age groups. These inequalities do not exist among immigrant women, and some groups of foreign mothers even have lower rates of low birth weight, preterm birth, and small for gestational age births than autochthonous women. The existing inequalities suggest that policy efforts to reduce these inequalities are not entirely successful and should focus on improving pregnancy and delivery care in less privileged women in a country with universal access to health care.
authors.affiliation: CIBER in Epidemiology and Public Health, Barcelona, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Garcia-Subirats
authors.forename: Glòria
authors.initials: G
authors.lastname: Pérez
authors.forename: Maica
authors.initials: M
authors.lastname: Rodríguez-Sanz
authors.forename: Joaquín
authors.initials: J
authors.lastname: Salvador
authors.forename: Mireia
authors.initials: M
authors.lastname: Jané
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D054624:Health Status Disparities; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008423:Maternal Age; D008429:Maternal Welfare; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012923:Social Class; D013030:Spain; D013223:Statistics as Topic; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult