Skip to main content

Advertisement

SpringerLink
Log in

Immigrants and Preterm Births: A Nationwide Epidemiological Study in Sweden

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

To examine, nationwide, if there is an association between country of birth in mothers and preterm birth and to study whether any such association remains in second-generation immigrant women. In this follow-up study, a nationwide research database located at Lund University, Sweden, was used to identify all preterm born singletons in Sweden between January 1, 1982, and December 31, 2006. Incidence ratios were standardized with regard to maternal age at birth, marital status, geographical region, body height, and smoking history as well as period of birth, family income, and gender of the infant. Singletons of mothers born in Sweden were used as the reference group. There were 2,192,843 records for singletons over the study period, of whom 4.9 % were preterm births and 0.8 % were very preterm births. Increased risk of preterm birth was observed for mothers from Austria, Yugoslavia, Romania, Central Europe, and Asia. Increased risk of very preterm birth was observed for mothers from Eastern Europe, Central Europe, Africa, and Asia; these increased risk disappeared, however, in the second-generation female immigrants. Country of birth in mothers affected the risk of preterm birth; maternity care should pay special attention to women from certain population groups.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bloomberg, L., Meyers, J., & Braverman, M. T. (1994). The importance of social interaction: a new perspective on social epidemiology, social risk factors, and health. Health Education Quarterly, 21, 447–463. (discussion 465–449).

    Article  PubMed  CAS  Google Scholar 

  2. Luo, Z. C., Wilkins, R., & Kramer, M. S. (2004). Disparities in pregnancy outcomes according to marital and cohabitation status. Obstetrics & Gynecology, 103, 1300–1307.

    Article  Google Scholar 

  3. Zeitlin, J. A., Ancel, P. Y., Saurel-Cubizolles, M. J., et al. (2001). Are risk factors the same for small for gestational age versus other preterm births? American Journal of Obstetrics and Gynecology, 185, 208–215.

    Article  PubMed  CAS  Google Scholar 

  4. Ananth, C. V., Berkowitz, G. S., Savitz, D. A., et al. (1999). Placental abruption and adverse perinatal outcomes. The Journal of the American Medical Association, 282, 1646–1651.

    Article  CAS  Google Scholar 

  5. Hedderson, M. M., Ferrara, A., & Sacks, D. A. (2003). Gestational diabetes mellitus and lesser degrees of pregnancy hyperglycemia: association with increased risk of spontaneous preterm birth. Obstetrics & Gynecology, 102, 850–856.

    Article  Google Scholar 

  6. Hobel, C., & Culhane, J. (2003). Role of psychosocial and nutritional stress on poor pregnancy outcome. Journal of Nutrition, 133, 1709S–1717S.

    PubMed  CAS  Google Scholar 

  7. Cnattingius, S. (2004). The epidemiology of smoking during pregnancy: smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine & Tobacco Research, 6(Suppl 2), S125–S140.

    Article  Google Scholar 

  8. Kramer, M. S., Goulet, L., Lydon, J., et al. (2001). Socio-economic disparities in preterm birth: causal pathways and mechanisms. Paediatric and Perinatal Epidemiology, 15(Suppl 2), 104–123.

    Article  PubMed  Google Scholar 

  9. Clausson, B., Cnattingius, S., & Axelsson, O. (1998). Preterm and term births of small for gestational age infants: a population-based study of risk factors among nulliparous women. British Journal of Obstetrics and Gynaecology, 105, 1011–1017.

    Article  PubMed  CAS  Google Scholar 

  10. Wolf, E. J., Mallozzi, A., Rodis, J. F., et al. (1991). Placenta previa is not an independent risk factor for a small for gestational age infant. Obstetrics & Gynecology, 77, 707–709.

    CAS  Google Scholar 

  11. Xiao, R., Sorensen, T. K., Williams, M. A., et al. (2003). Influence of pre-eclampsia on fetal growth. The Journal of Maternal-fetal Medicine, 13, 157–162.

    Article  CAS  Google Scholar 

  12. Strauss, R. S., & Pollack, H. A. (2001). Epidemic increase in childhood overweight, 1986–1998. The Journal of the American Medical Association, 286, 2845–2848.

    Article  CAS  Google Scholar 

  13. Popkin, B. M., & Gordon-Larsen, P. (2004). The nutrition transition: worldwide obesity dynamics and their determinants. International Journal of Obesity and Related Metabolic Disorders, 28(Suppl 3), S2–S9.

    Article  PubMed  Google Scholar 

  14. Ferrara, A., Kahn, H. S., Quesenberry, C. P., et al. (2004). An increase in the incidence of gestational diabetes mellitus: Northern California, 1991–2000. Obstetrics & Gynecology, 103, 526–533.

    Article  Google Scholar 

  15. Dejin-Karlsson, E., & Ostergren, P. O. (2003). Psychosocial factors, lifestyle, and fetal growth: the added value of both pre- and post-natal assessments. The European Journal of Health Economics, 13, 210–217.

    Article  Google Scholar 

  16. Wiking, E., Johansson, S. E., & Sundquist, J. (2004). Ethnicity, acculturation, and self reported health. A population based study among immigrants from Poland, Turkey, and Iran in Sweden. Journal of Epidemiology and Community Health, 58, 574–582.

    Article  PubMed  Google Scholar 

  17. Robertson, E., Malmstrom, M., & Johansson, S. E. (2005). Do foreign-born women in Sweden have an increased risk of non-normal childbirth? Acta Obstetricia et Gynecologica Scandinavica, 84, 825–832.

    PubMed  Google Scholar 

  18. Sundquist, J., Malmstrom, M., & Johansson, S. E. (1999). Cardiovascular risk factors and the neighbourhood environment: a multilevel analysis. International Journal of Epidemiology, 28, 841–845.

    Article  PubMed  CAS  Google Scholar 

  19. Statistics Sweden: Statistical yearbook of Sweden 1996–2000. In Statistics Sweden; 2000.

  20. Epidemiology TSCf: The Swedish Medical Birth Register: A summary of content and quality (http://www.sos.se/epc/epceng.htm). 2003.

  21. SAS: SAS software Release 9.1. In Release 9.1, eds. Cary, NC, USA: SAS institute Inc. 2002–2003.

  22. Parker, J. D., Schoendorf, K. C., & Kiely, J. L. (1994). Associations between measures of socioeconomic status and low birth weight, small for gestational age, and premature delivery in the United States. Annals of Epidemiology, 4, 271–278.

    Article  PubMed  CAS  Google Scholar 

  23. Wilcox, M. A., Smith, S. J., Johnson, I. R., et al. (1995). The effect of social deprivation on birthweight, excluding physiological and pathological effects. British Journal of Obstetrics and Gynaecology, 102, 918–924.

    Article  PubMed  CAS  Google Scholar 

  24. Kogan, M. D. (1995). Social causes of low birth weight. Journal of the Royal Society of Medicine, 88, 611–615.

    PubMed  CAS  Google Scholar 

  25. Ancel, P. Y., Saurel-Cubizolles, M. J., Di Renzo, G. C., et al. (1999). Social differences of very preterm birth in Europe: interaction with obstetric history. Europop Group. American Journal of Epidemiology, 149, 908–915.

    Article  PubMed  CAS  Google Scholar 

  26. Kramer, M. S., Seguin, L., Lydon, J., et al. (2000). Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatric and Perinatal Epidemiology, 14, 194–210.

    Article  PubMed  CAS  Google Scholar 

  27. Vangen, S., Stoltenberg, C., Skjaerven, R., et al. (2002). The heavier the better? Birthweight and perinatal mortality in different ethnic groups. International Journal of Epidemiology, 31, 654–660.

    Article  PubMed  Google Scholar 

  28. Koupilova, I., Vagero, D., Leon, D. A., et al. (1998). Social variation in size at birth and preterm delivery in the Czech Republic and Sweden, 1989–91. Paediatric and Perinatal Epidemiology, 12, 7–24.

    Article  PubMed  CAS  Google Scholar 

  29. Olsen, P., Laara, E., Rantakallio, P., et al. (1995). Epidemiology of preterm delivery in two birth cohorts with an interval of 20 years. American Journal of Epidemiology, 142, 1184–1193.

    PubMed  CAS  Google Scholar 

  30. Sanjose, S., Roman, E., & Beral, V. (1991). Low birthweight and preterm delivery, Scotland, 1981–84: effect of parents’ occupation. Lancet, 338, 428–431.

    Article  PubMed  CAS  Google Scholar 

  31. Wilkins, R., Sherman, G. J., & Best, P. A. (1991). Birth outcomes and infant mortality by income in urban Canada, 1986. Health Reports, 3, 7–31.

    PubMed  CAS  Google Scholar 

  32. Ferguson, S. E., Smith, G. N., Salenieks, M. E., et al. (2002). Preterm premature rupture of membranes. Nutritional and socioeconomic factors. Obstetrics & Gynecology, 100, 1250–1256.

    Article  Google Scholar 

  33. Wise, P., Chavkin, W., & Romero, D. (1999). Assessing the effects of welfare reform policies on reproductive and infant health. American Journal of Public Health, 89, 1514–1521.

    Article  PubMed  CAS  Google Scholar 

  34. Shah, P. S., Zao, J., & Ali, S. (2011). Maternal marital status and birth outcomes: a systematic review and meta-analyses. Maternal and Child Health Journal, 15, 1097–1109.

    Article  PubMed  Google Scholar 

  35. Essen, B., Bodker, B., Sjoberg, N. O., et al. (2002). Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services? British Journal of Obstetrics and Gynaecology, 109, 677–682.

    PubMed  Google Scholar 

  36. Urquia, M. L., Glazier, R. H., Blondel, B., et al. (2010). International migration and adverse birth outcomes: role of ethnicity, region of origin and destination. Journal of Epidemiology and Community Health, 64, 243–251.

    Article  PubMed  Google Scholar 

  37. Collins, J. W, Jr, Wu, S. Y., & David, R. J. (2002). Differing intergenerational birth weights among the descendants of US-born and foreign-born Whites and African Americans in Illinois. American Journal of Epidemiology, 155, 210–216.

    Article  PubMed  Google Scholar 

  38. Petersen, C. B., Mortensen, L. H., Morgen, C. S., et al. (2009). Socio-economic inequality in preterm birth: a comparative study of the Nordic countries from 1981 to 2000. Paediatric and Perinatal Epidemiology, 23, 66–75.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by the National Institute of Child Health and Human Development (1R01HD052848-01), the Swedish Research Council (K2012-70X-15428-08-3) and EU and North African Migrants (EUNAM) (EU FP7/2007–2013 grant 260715), the Swedish Council for Working Life and Social Research (2006-0386, 2007-1754 and 2007-1962) and an ALF project grant from the Region of Skåne, Sweden.

Conflict of interest

There are no conflicts of interest.

Author information

Authors and Affiliations

  1. Center for Primary Health Care Research, Clinical Research Centre (CRC), Building 28, Entrance 72, Jan Waldenströms gata 35, Skåne University Hospital, Lund University, 205 02, Malmö, Sweden

    Xinjun Li, Jan Sundquist & Kristina Sundquist

  2. Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA

    Jan Sundquist & Kristina Sundquist

Authors
  1. Xinjun Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jan Sundquist
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kristina Sundquist
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xinjun Li.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Li, X., Sundquist, J. & Sundquist, K. Immigrants and Preterm Births: A Nationwide Epidemiological Study in Sweden. Matern Child Health J 17, 1052–1058 (2013). https://doi.org/10.1007/s10995-012-1087-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-012-1087-7

Keywords

Search

Navigation