Trends and disparities in perinatal health outcomes among women from refugee backgrounds in Victoria, Australia: A population-based study

Yordanos Gizachew Yeshitila; Lisa Gold; Elisha Riggs; Julie Abimanyi-Ochom; Linda Sweet; Ha N D Le

doi:10.1016/j.midw.2024.103980

Trends and disparities in perinatal health outcomes among women from refugee backgrounds in Victoria, Australia: A population-based study

Midwifery. 2024 May:132:103980. doi: 10.1016/j.midw.2024.103980. Epub 2024 Mar 20.

Authors

Yordanos Gizachew Yeshitila¹, Lisa Gold², Elisha Riggs³, Julie Abimanyi-Ochom², Linda Sweet⁴, Ha N D Le²

Affiliations

¹ Institute for Health Transformation, Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, 1Gheringhap Street, Geelong, Victoria 3220, Australia; School of Nursing, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia; Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia. Electronic address: y.yeshitila@deakin.edu.au.
² Institute for Health Transformation, Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, 1Gheringhap Street, Geelong, Victoria 3220, Australia.
³ Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of General Practice, The University of Melbourne, Victoria, Melbourne, Australia.
⁴ School of Nursing and Midwifery, Deakin University, Victoria, Australia; Centre for Quality and Patient Safety Research, Western Health Partnership, Institute for Health Transformation, Victoria, Australia.

PMID: 38547597
DOI: 10.1016/j.midw.2024.103980

Abstract

Background: Women from refugee backgrounds generally experience poorer pregnancy-related outcomes compared to host populations.

Aim: To examine the trend and disparities in adverse perinatal outcomes among women of refugee background using population-based data from 2003 to 2017.

Methods: A population-based cross-sectional study of 754,270 singleton births in Victoria compared mothers of refugee backgrounds with Australian-born mothers. Inferential statistics, including Pearson chi-square and binary logistic regression, were conducted. Multiple logistic regression was conducted to explore the relationship between adverse perinatal outcomes and the women's refugee status.

Findings: Women of refugee background had higher odds of adverse neonatal and maternal outcomes, including stillbirth, neonatal death, low APGAR score, small for gestational age, postpartum haemorrhage, abnormal labour, perineal tear, and maternal admission to intensive care compared to Australian-born women. However, they had lower odds of neonatal admission to intensive care, pre-eclampsia, and maternal postnatal depression. The trend analysis showed limited signs of gaps closing over time in adverse perinatal outcomes.

Discussion and conclusion: Refugee background was associated with unfavourable perinatal outcomes, highlighting the negative influence of refugee status on perinatal health. This evidences the need to address the unique healthcare requirements of this vulnerable population to enhance the well-being of mothers and newborns. Implementing targeted interventions and policies is crucial to meet the healthcare requirements of women of refugee backgrounds. Collaborative efforts between healthcare organisations, government agencies and non-governmental organisations are essential in establishing comprehensive support systems to assist refugee women throughout their perinatal journey.

Keywords: Maternal outcomes; Neonatal outcomes; Perinatal health; Refugees.

MeSH terms

Adult
Cross-Sectional Studies
Female
Humans
Infant, Newborn
Logistic Models
Pregnancy
Pregnancy Complications / epidemiology
Pregnancy Complications / ethnology
Pregnancy Outcome* / epidemiology
Pregnancy Outcome* / ethnology
Refugees* / psychology
Refugees* / statistics & numerical data
Victoria / epidemiology