Does a migration background lead to inferior maternal child health?

Current political focus on academic attainment and juvenile violence of non-German citizens raises questions of adequate care of minorities with a migrant background. Population based data on the quality of maternal child health contain information on motherrsquor;s country of origin as well as antenatal care and outcome of mother and child. The chief aim was to inspect the available data with a view to identifying populations currently at risk. 923670 Bavarian singleton maternities in the period 1998–2007 were analysed. Smoothed time series were used to assess trends. Logistic regression analysis was used to extract odds ratios adjusted for confounders such as age and parity. Motherrsquor;s country of origin was dichotomised for the logistic regressions. Country of origin breaks down as German (82.2%), European-American (2.0%), Mediterranean (3.9%), Eastern European (4.7%), Oriental-African (4.5%), Asian (1.1%) and other (1.6%). Migrant status bears significantly on incidence of stillbirths (OR=1.23), premature delivery under 32 weeks (OR=1.32), neonatal acidosis (OR=1.08), late initial antenatal care visit (OR=1.92) and number of antenatal care visits (OR=2.00). Perineal tears degree 3 and higher were significantly lower in migrants (OR=0.92) after adjustment for age, parity and year of birth. The higher incidence of mortality and morbidity in the migrant population is paralleled by a lower intensity of antenatal care with the exception of perineal tears where only the Asian population exceed German levels. Whilst the uptake of medical care services may depend on cultural factors migrant status, as a proxy for lower educational attainment, clearly identifies populations still at risk.

migrant health - maternal morbidity - child health - nationality