Perinatal outcomes of immigrant women of Turkish, Middle Eastern and North African origin in Berlin, Germany: a comparison of two time periods.
OBJECTIVE
Publications based on data from perinatal health registries reported worse perinatal health outcomes among women of Turkish origin. The aim of this study was to compare the perinatal outcomes of women of German and Turkish origin in Berlin in two time periods and to analyze if the situation among the women of Turkish origin has improved over time.


METHODS
Datasets of all singleton deliveries from Berlin hospitals for the time periods 1993-1997 (n = 144,600) and 2003-2007 (n = 147,559) were used. Incidence rates resp. prevalences of perinatal health outcomes were computed for women of German and a group of immigrant women mostly of Turkish origin stratified for 'parity' and 'having a partner'. Logistic regression models were computed to test for a change in the odds for adverse perinatal outcomes over time.


RESULTS
The chances for adverse perinatal outcomes were decreasing in the later time period for most measures. For stillbirth, preterm birth and congenital malformations, no differences between women of Turkish and German origin could be found. Differences exist in the utilization of perinatal health care and in the risk for anemia. Among women of Turkish origin, the chance for being anemic is even higher in 2003-2007 compared to 1993-1997.


CONCLUSIONS
The perinatal health measures of women of Turkish origin have improved over time. The lower utilization rates of antenatal health care could be the expression of barriers to access the health care for pregnant women with migration background as offered in Germany. A risk group which needs a special focus by health care providers are women without a partner, irrespective of their origin.
Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany, jacob.spallek@uni-bielefeld.de.
Jacob
J
Spallek
Jessica
J
Lehnhardt
Anna
A
Reeske
Oliver
O
Razum
Matthias
M
David
D000293:Adolescent; D000328:Adult; D000352:Africa, Northern / Q000208:ethnology; D000740:Anemia / Q000453:epidemiology / Q000208:ethnology*; D001604:Berlin / Q000453:epidemiology; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000208:ethnology*; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008423:Maternal Age; D008877:Middle East / Q000208:ethnology; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000208:ethnology*; D011256:Pregnancy Outcome / Q000453:epidemiology / Q000208:ethnology*; D047928:Premature Birth / Q000453:epidemiology / Q000208:ethnology*; D012042:Registries; D012307:Risk Factors; D015406:Single Parent; D012907:Smoking / Q000453:epidemiology / Q000208:ethnology; D050497:Stillbirth / Q000453:epidemiology / Q000208:ethnology*; D014421:Turkey / Q000208:ethnology