Gagnon A J, Zimbeck M, Zeitlin J, Alexander Sophie, Blondel Béatrice, Buitendijk Simone, Desmeules Marie, Di Lallo Dominico, Gagnon Anita, Gissler Mika, Glazier Richard, Heaman Maureen, Korfker Dineke, Macfarlane Alison, Ng Edward, Roth Carolyn, Small Rhonda, Stewart Donna, Stray-Pederson Babill, Urquia Marcelo, Vangen Siri, Zeitlin Jennifer, Zimbeck Meg
McGill University, Montreal, Quebec, Canada; McGill University Health Centre, Montreal, Quebec, Canada.
Soc Sci Med. 2009 Sep;69(6):934-46. doi: 10.1016/j.socscimed.2009.06.027. Epub 2009 Aug 5.
Influxes of migrant women of childbearing age to receiving countries have made their perinatal health status a key priority for many governments. The international research collaboration Reproductive Outcomes And Migration (ROAM) reviewed published studies to assess whether migrants in western industrialised countries have consistently poorer perinatal health than receiving-country women. A systematic review of literature from Medline, Health Star, Embase and PsychInfo from 1995 to 2008 included studies of migrant women/infants related to pregnancy or birth. Studies were excluded if there was no cross-border movement or comparison group or if the receiving country was not western and industrialised. Studies were assessed for quality, analysed descriptively and meta-analysed when possible. We identified 133 reports (>20,000,000 migrants), only 23 of which could be meta-analysed. Migrants were described primarily by geographic origin; other relevant aspects (e.g., time in country, language fluency) were rarely studied. Migrants' results for preterm birth, low birthweight and health-promoting behaviour were as good or better as those for receiving-country women in >or=50% of all studies. Meta-analyses found that Asian, North African and sub-Saharan African migrants were at greater risk of feto-infant mortality than 'majority' receiving populations, and Asian and sub-Saharan African migrants at greater risk of preterm birth. The migration literature is extensive, but the heterogeneity of the study designs and definitions of migrants limits the conclusions that can be drawn. Research that uses clear, specific migrant definitions, adjusts for relevant risk factors and includes other aspects of migrant experience is needed to confirm and understand these associations.
育龄期移民女性涌入接收国，使得她们的围产期健康状况成为许多政府的关键优先事项。国际研究合作项目“生殖结局与移民”（ROAM）回顾了已发表的研究，以评估西方工业化国家的移民围产期健康状况是否始终比接收国女性差。对1995年至2008年来自Medline、Health Star、Embase和PsychInfo的文献进行系统回顾，纳入了与怀孕或分娩相关的移民女性/婴儿研究。如果没有跨境流动或对照组，或者接收国不是西方工业化国家，则排除相关研究。对研究进行质量评估，进行描述性分析，并在可能的情况下进行荟萃分析。我们识别出133份报告（超过2000万移民），其中只有23份可以进行荟萃分析。移民主要按地理来源进行描述；很少研究其他相关方面（如在该国的时间、语言流利程度）。在所有研究中，超过或等于50%的研究显示，移民在早产、低出生体重和促进健康行为方面的结果与接收国女性相当或更好。荟萃分析发现，亚洲、北非和撒哈拉以南非洲的移民胎儿及婴儿死亡风险高于“多数”接收人群，亚洲和撒哈拉以南非洲的移民早产风险更高。关于移民的文献很多，但研究设计的异质性和移民定义限制了能够得出的结论。需要开展使用清晰、具体的移民定义、对相关风险因素进行调整并纳入移民经历其他方面的研究，以证实和理解这些关联。
