Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada.
Department of Pediatrics, McGill University, Montreal, Canada.
J Public Health (Oxf). 2020 Feb 28;42(1):e26-e33. doi: 10.1093/pubmed/fdz006.
To examine perinatal health differences between foreign-born and native-born mothers in Canada across multiple outcomes and two cohorts 10 years apart.
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.
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.
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.
本研究旨在对比加拿大出生的母亲和移民母亲在多个围产儿结局方面的差异，并通过两个时间间隔 10 年的队列进行研究。
本研究分别使用了 1996 年和 2006 年加拿大人口普查-出生队列中 94896 例和 131271 例活产儿的数据，评估了移民母亲和加拿大本地母亲在早产（PTB）、小于胎龄儿（SGA）、大于胎龄儿（LGA）、死胎和婴儿死亡率方面的风险比和风险差异。
在 1996 年的队列中，我们没有发现移民母亲和本地母亲在不良围产儿结局方面存在显著差异。然而，在 2006 年的队列中，移民母亲的 PTB、LGA、死胎和婴儿死亡率风险较低，SGA 风险较高，无论在相对还是绝对水平上均如此。在 2006 年的队列中，还观察到白人、东亚裔、东南亚裔和南亚裔移民母亲的 PTB 风险降低。在移民母亲中，2006 年队列中 PTB 风险的降低也与在加拿大的居住时间呈负相关。
母亲移民身份与围产儿健康的差异在不同队列中有所不同，并且在最近的移民中观察到更明显的“健康移民”效应。这种差异可能与本地母亲的围产儿健康状况以及近年来更为严格/选择性的移民政策有关。
