title: Favorable neonatal outcomes among immigrants in Taiwan: evidence of healthy immigrant mother effect.
abstract: BACKGROUND
  Although racial/ethnic disparities in neonatal and infant health are well known, positive associations between migration and perinatal health exist among immigrant mothers in western countries. There are unique marriage migration, East Asia culture, universal national health insurance system, and adequate social support in Taiwan that may differ from the situation in western countries. We aimed to assess the neonatal outcomes among live births to married immigrant mothers in recent years in Taiwan.
  
  
  METHODS
  We conducted a population-based analysis among all the live births in Taiwan during the period 1998-2003 to assess neonatal outcomes, including incidence of low birth weight and preterm birth and of early and late neonatal mortality, according to maternal nationality. Logistic regression was used to estimate the odds ratios (ORs) associated with low birth weight and preterm birth, and Cox proportional hazards were used to estimate the relative risks (RRs) associated with mortality in the neonatal period.
  
  
  RESULTS
  There were a total of 1,405,931 single live births, including 6.6% born to immigrant mothers and 93.4% born to Taiwanese mothers. Disparities existed among the intercultural couples, including paternal age, parental educational level, and residential distribution. Fewer low birth weight and fewer preterm babies were born to immigrant mothers than to Taiwanese mothers. In addition, babies born to immigrant mothers had lower early neonatal and neonatal mortalities than those born to Taiwanese mothers. There were lower risks of having a low birth weight (adjusted OR [AOR] 0.73, 95% confidence interval [CI] 0.70-0.75) or preterm (AOR 0.72, 95% CI 0.69-0.74) baby and lower hazard ratios (HRs) of having an early neonatal death (adjusted HR [AHR] 0.68, 95% CI 0.56-0.82) or neonatal death (AHR 0.74, 95% CI 0.64-0.87) in babies born to immigrant mothers. There is a gradual increase in the risks of adverse neonatal outcomes associated with increases in length of residence.
  
  
  CONCLUSIONS
  Evidence of a healthy immigrant mother effect on neonatal health is clear. Despite lower parental education, advancing paternal age, and spatial distribution disparity, babies born to married immigrant mothers in Taiwan had favorable neonatal outcomes.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Wu-Shiun
authors.initials: WS
authors.lastname: Hsieh
authors.forename: Chia-Jung
authors.initials: CJ
authors.lastname: Hsieh
authors.forename: Suh-Fang
authors.initials: SF
authors.lastname: Jeng
authors.forename: Hua-Fang
authors.initials: HF
authors.lastname: Liao
authors.forename: Yi-Ning
authors.initials: YN
authors.lastname: Su
authors.forename: Shio-Jean
authors.initials: SJ
authors.lastname: Lin
authors.forename: Pei-Jen
authors.initials: PJ
authors.lastname: Chang
authors.forename: Pau-Chung
authors.initials: PC
authors.lastname: Chen
mesh_terms: D044466:Asian People / Q000706:statistics & numerical data*; D002681:China / Q000208:ethnology; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D007229:Infant Welfare / Q000208:ethnology*; D007231:Infant, Newborn; D009035:Mothers / Q000706:statistics & numerical data*; D018743:Perinatal Care / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology; D014744:Vietnam / Q000208:ethnology