title: Rising disparities in severe adverse birth outcomes among Haitians in Québec, Canada, 1981-2006.
abstract: Perinatal health data for Haitians are scant. We evaluated adverse birth outcomes for Haitians in Québec, Canada. We analyzed 2,124,909 live births from 1981 to 2006. Haitian ethnicity was assessed using maternal birth country (Haiti, other Caribbean country, other foreign country, Canada) and home language (Creole, French/English but Creole mother tongue, French/English, other). Associations between ethnicity and preterm birth (PTB), low birth weight (LBW), and small-for-gestational-age (SGA) birth were calculated. Adverse birth outcomes were more common among mothers with Haitian ethnicity. Relative to Canadian-born mothers, odds for Haitian-born mothers were 4 times greater for extreme PTB (≤27 weeks), twice greater for very PTB (28-31 weeks), and 25% higher for moderate PTB (32-36 weeks). Patterns were similar for SGA birth and severe cases of LBW. Despite overall decreases LBW and SGA birth, relative and absolute inequalities increased over time. Perinatal health inequalities are increasing for Haitian-born mothers.
authors.affiliation: Institut National de santé publique du Québec, 190, boulevard Crémazie Est, Montréal, QC, H2P 1E2, Canada. nathalie.auger@inspq.qc.ca
authors.forename: Nathalie
authors.initials: N
authors.lastname: Auger
authors.forename: Martine
authors.initials: M
authors.lastname: Chery
authors.forename: Mark
authors.initials: M
authors.lastname: Daniel
mesh_terms: D000328:Adult; D004522:Educational Status; D005260:Female; D047109:Fetal Development; D006205:Haiti / Q000453:epidemiology; D054624:Health Status Disparities; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology*; D011256:Pregnancy Outcome / Q000208:ethnology*; D047928:Premature Birth / Q000208:ethnology*; D011792:Quebec / Q000208:ethnology