Evaluation of the Risk of Adverse Maternal and Neonatal Outcomes Among Immigrant and Native-Born Women: A Retrospective Observational Analysis

Background and Aims: Although ethnic disparities in birth outcomes have been well documented, it is unclear whether certain immigrant groups have a higher risk of suffering from perinatal complications compared to native-born Spanish women. The objective of this study was to identify prenatal and perinatal complications among immigrant populations and residents of a region of Catalonia. Methods: A retrospective observational cohort study was conducted among pregnant women in the Lleida health region between 2012 and 2018. Perinatal indicators of obstetric outcomes were compared between the immigrant and native-born Spanish population. The risk was calculated using univariate and multivariate logistic regression analysis. Results: A sample of 17,281 women, accounting for over 92% of the pregnant population in the Lleida health region, was analyzed. Among this sample, preeclampsia occurred in 2.4% of sub-Saharan women. They also presented the highest percentage of cesarean sections of 22.5%. Apgar score in the first minute < 7 was observed in 4.6% of newborns of sub-Saharan mothers compared to 2.3%–2.5% of the rest (other immigrant populations plus native populations). The populations from Latin America had a higher risk of cesarean sections (21.6%) and macrosomia (8.7%). Women from Eastern Europe had a lower percentage of cesarean sections (15.9%). The Maghreb population had a lower percentage of cesarean sections (15.5%) and a lower birth weight (3.2%). However, a higher macrosomia percentage of 10.7% was observed. Conclusions: Differences are observed in the risk during pregnancy and in the newborn between the immigrant and the national population. These data corroborate the exposure to greater risk by the immigrant population, a preventive approach and early treatment is necessary to avoid complications in the mother and the newborn.