Risk of pregnancy complications increased in certain immigrant groups

A cross-country study of more than 9 million deliveries shows that immigrant women from sub-Saharan Africa, Latin America, and the Caribbean may be at increased risk of preeclampsia and eclampsia. Published in the British Journal of Obstetrics and Gynaecology, the findings point to a need for increased prenatal surveillance in women in these groups.

Canadian researchers compared differences in preeclampsia and eclampsia rates among immigrants and native-born women in six industrialized countries: Australia, Canada, Denmark, Sweden, Spain, and the United States. Included were more than 3 million births to women who immigrated from Western Europe, sub-Saharan Africa, and Latin America and the Caribbean. The data were from the most recent 10-year period available to each participating center (1995–2010).

A higher risk of preeclampsia was found in women who immigrated from sub-Saharan Africa and Latin America and the Caribbean compared with those who immigrated from Western Europe (OR: 1.72; 95% CI: 1.63, 1.80, and 1.63; 95% CI: 1.57, 1.69). A similar increase in risk among those immigrant groups was seen for eclampsia (OR: 2.12; 95% CI: 1.61, 2.79 and 1.55; 95% CI: 1.26, 1.91). The associations held true even after adjustment for parity, maternal age, and destination country. European and East Asian immigrants were at lower risk than women in most industrialized countries. The lowest risks were seen in Australia and the greatest disparities were seen in Spain.

In a press release about the study, lead author Marcelo Urquia said that “obstetricians and midwives should consider pregnancies for immigrants from these regions as high risk,” noting that the women “need enhanced surveillance and culturally sensitive care.”

Urguia M, Glazier R, Gagnon A, et al. Disparities in preeclampsia and eclampsia among immigrant women giving birth in six industrialised countries. BJOG. 2014 Apr 24. DOI: 10.1111/1471-0528.12758 [Epub ahead of print].