title: Higher risk for adverse obstetric outcomes among immigrants of African and Asian descent: a comparison study at a low-risk maternity hospital in Norway.
abstract: BACKGROUND
  Immigrants have higher risks for some adverse obstetric outcomes, and 40 percent of women giving birth at the low-risk maternity ward in Baerum Hospital, Norway, are immigrants. This study compared obstetric outcomes between immigrants and ethnic Norwegians giving birth in a low-risk setting.
  
  
  METHODS
  This was a population-based study linking the Medical Birth Registry of Norway to Statistics Norway. The study included the first registered birth during the study period to immigrant and ethnic Norwegian women at Baerum Hospital from 2006 to 2010. The main outcome measures were onset of labor, operative vaginal delivery, cesarean delivery, episiotomy, postpartum bleeding > 500 mL, epidural analgesia, labor dystocia, gestational age, meconium-stained liquor, 5-minute Apgar score, birthweight, and transfer to a neonatal intensive care unit.
  
  
  RESULTS
  A total of 11,540 women originating from 141 countries were divided into seven groups. Compared with Norwegians, women from East, Southeast, and Central Asia had increased risk for operative vaginal delivery, postpartum bleeding, and low Apgar score. The African women had increased risk for postterm birth, meconium-stained liquor, episiotomy, operative vaginal delivery, emergency cesarean delivery, postpartum bleeding, low Apgar score, and low birthweight. Women from South and Western Asia had increased risk for low birthweight.
  
  
  CONCLUSIONS
  Obstetric outcomes of immigrants differ significantly from those of Norwegians, even in a low-risk maternity unit. Thus, immigrant women would benefit from more targeted care during pregnancy and childbirth, even in low-risk settings.
authors.affiliation: Department of Gynecology and Obstetrics, Baerum Hospital, Vestre Viken Hospital Trust, Rud, Norway.|Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Kjersti S
authors.initials: KS
authors.lastname: Bakken
authors.affiliation: Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Ghotenburg, Sweden.
authors.forename: Ola H
authors.initials: OH
authors.lastname: Skjeldal
authors.affiliation: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.|Women and Children's Division, Oslo University Hospital, Oslo, Norway.|Norwegian Resource Centre for Women's Health, Oslo University Hospital, Oslo, Norway.
authors.forename: Babill
authors.initials: B
authors.lastname: Stray-Pedersen
mesh_terms: D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006771:Hospitals, Maternity / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D009664:Norway / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D018570:Risk Assessment
keywords: birth outcomes; country of origin; immigrant; low-risk maternity hospital; obstetric outcomes