title: The association between maternal country of birth and neonatal intensive care unit outcomes.
abstract: BACKGROUND
  Immigration is increasingly common worldwide and its impact on neonatal intensive care unit outcomes is uncertain.
  
  
  OBJECTIVE
  To determine the outcomes of children of immigrant mothers admitted to NICUs in New South Wales (NSW), Australia, between 2000 and 2006.
  
  
  METHODS
  Record linkage study of routinely collected state-based health databases.
  
  
  METHODS
  Infants of Australian-born (9813, 81.9%) and overseas born mothers (2166, 18.1%).
  
  
  METHODS
  NICU and childhood outcomes to a maximum 5 years of age.
  
  
  RESULTS
  Immigrant mothers came from 122 countries, 897 (44%) from high income regions. Australian born mothers were more likely to be teenaged (Odds Ratio, 95% confidence interval: 3.07, 2.21-4.26), use drugs (3.55, 2.49-5.06) and suffer an antepartum hemorrhage (1.29, 1.14-1.48). They were less likely to have gestational diabetes (0.45, 0.38-0.54), fetal distress (0.75, 0.66-0.85) and intrauterine growth restriction (0.80, 0.67-0.93). Their infants were more likely to be admitted to the NICU for prematurity but less likely to have low 5 min Apgar scores (0.81, 0.69-0.93) or a congenital abnormality (0.79, 0.70-0.90). Infants of Middle-Eastern mothers had the lowest hospital survival rate (88.5%). Children of immigrant Asian mothers were least likely to be rehospitalized after NICU discharge (1.66, 1.27-2.17).
  
  
  CONCLUSIONS
  NICU outcomes are affected by maternal country of birth even within the same ethnic group. Further study regarding the impact of paternal race and immigration status and duration of residency will provide data for the changing cultural environment of global perinatal care.
authors.affiliation: Department of Newborn Care, Royal Hospital for Women, Randwick, NSW, Australia.
authors.forename: Preena
authors.initials: P
authors.lastname: Uppal
authors.forename: Andrew J A
authors.initials: AJ
authors.lastname: Holland
authors.forename: Barbara
authors.initials: B
authors.lastname: Bajuk
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Latif
authors.forename: Adam
authors.initials: A
authors.lastname: Jaffe
authors.forename: Lisa
authors.initials: L
authors.lastname: Hilder
authors.forename: Kei
authors.initials: K
authors.lastname: Lui
authors.forename: Ju Lee
authors.initials: JL
authors.lastname: Oei
mesh_terms: D000328:Adult; D001315:Australia; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D007226:Infant Mortality / Q000208:ethnology*; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data*; D008297:Male; D009035:Mothers; D016896:Treatment Outcome