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Perinatal health among foreign versus native-born mothers in Canada: Variations across outcomes and cohorts

TitlePerinatal health among foreign versus native-born mothers in Canada: Variations across outcomes and cohorts
Year of Publication2020
AuthorsYang, S., Dahhou M., Bushnik T., Wilkins R., Kaufman J. S., Sheppard A. J., and Kramer M. S.
JournalJournal of Public Health
Pagese26 - e33
Keywordsasian, birth, canada censuses, epidemiology, fetal death, immigrants, infant, infant mortality, macrosomia, migration, mothers, perinatal period, pregnancy and childbirth disorders, small for gestational age

Background To examine perinatal health differences between foreign-born and native-born mothers in Canada across multiple outcomes and two cohorts 10 years apart. Methods Using 94 896 and 131 271 births in the 1996 and 2006 Canadian Census-Birth Cohort, respectively, we estimated risk ratios and risk differences of preterm birth (PTB), small-for-gestational age (SGA), large-for-gestational age (LGA), stillbirth and infant mortality between foreign-born and Canadian-born mothers. Results In the 1996 cohort, we observed no important differences in adverse outcomes between foreign-born and native-born mothers. In the 2006 cohort, however, foreign-born mothers had lower risks of PTB, LGA, stillbirth, and infant mortality and a higher risk of SGA on both the relative and absolute scales. Lowered risk of PTB among foreign-born mothers in the 2006 cohort was also observed within Caucasian, East Asian, Southeast Asian and South Asian mothers. Favourable outcomes associated with foreign-born status in the 2006 cohort were negatively graded by duration of residence in Canada among immigrant mothers. Conclusions Differences in perinatal health by maternal foreign-born status varied across cohorts and a more pronounced 'healthy migrant' effect was observed among more recent migrants. The native-born mothers' perinatal health over time and a more restrictive/selective immigration policy in recent years would explain our results.

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