Too heavy, too late: investigating perinatal health outcomes in immigrants residing in Spain. A cross-sectional study (2009-2011).
BACKGROUND
Studies have shown that immigrants residing in Spain have lower risks of delivering low birthweight (LBW) and preterm babies despite their socioeconomic disadvantages (the healthy migrant paradox). However, less is known about other important perinatal outcomes derived from birth weight and gestational age such as macrosomia and post-term birth. This paper aims to compare the main indicators related to birth weight and gestational age (LBW, macrosomia, preterm and post-term) for immigrants and Spaniards.


METHODS
Cross-sectional study based on the Spanish vital statistics for years 2009-2011. Multinomial regression models were performed to obtain crude and adjusted ORs and their 95% CIs.


RESULTS
After adjusting for known confounders, compared with Spaniards, most immigrant groups show lower or not significantly different risks of delivering LBW (OR between 0.65 and 0.87) or, more exceptionally, preterm babies (between 0.75 and 0.93). However, most of them also show higher risks of delivering macrosomic (OR between 1.21 and 2.58) and post-term babies (OR between 1.11 and 1.50). Mothers from sub-Saharan Africa show a higher risk in all perinatal outcomes studied.


CONCLUSIONS
The immigrant health paradox should be carefully assessed in comprehensive terms. Together with a predominantly lower risk of LBW, most immigrants have a higher risk of macrosomia, post-term and preterm births. These results have policy-making implications since studying the right tail of the birth weight and gestational age distributions implies considering a different set of risk factors.
Centre for Economic Demography, Lund University, Lund, Sweden Institute for Futures Studies, Stockholm, Sweden.
Sol P
SP
Juárez
Centre for Economic Demography, Lund University, Lund, Sweden Institut National d'Études Démographiques, Paris, France.
Bárbara A
BA
Revuelta-Eugercios
D000328:Adult; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D005865:Gestational Age; D054624:Health Status Disparities; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D012923:Social Class; D013030:Spain / Q000453:epidemiology; D014798:Vital Statistics
MIGRATION; PERINATAL; PERINATAL EPIDEMIOLOGY