TY - JOUR

T1 - Perinatal Outcomes of Immigrant Mothers and Their Infants Born Very Preterm across Germany

AU - Hüning, Britta M.

AU - Jaekel, Julia

AU - Jaekel, Nils

AU - Göpel, Wolfgang

AU - Herting, Egbert

AU - Felderhoff-Müser, Ursula

AU - Spiegler, Juliane

AU - Härtel, Christoph

N1 - Funding Information: Funding: The GNN was funded by the German Ministry for Education and Research (BMBF), grant #01ER0805 and #01ER1501. The funder was not involved in the study design; collection, analyses, or interpretation of data; in the writing of this report; or in the decision to submit this manuscript for publication. Publisher Copyright: © 2024 by the authors.

PY - 2024/6

Y1 - 2024/6

N2 - Background: In Germany, more than 40% of infants are born to immigrant parents. Increased survival rates of very preterm (below 32 weeks gestation at birth; VP) infants have not resulted in equally improved life chances and quality of life. More information on perinatal variations in outcomes according to social inequalities, migration background, and language barriers is needed. We tested whether mothers’ immigrant status and language barriers are associated with perinatal health and short-term neonatal outcomes. Methods: The data are from the national multi-centre German Neonatal Network (GNN) cohort, including VP births from 2009 onwards. In total, 3606 (n = 1738 female) children were assessed, and 919 (n = 449 female) of these children had immigrant backgrounds. Immigrant status was operationalised as a binary variable based on the children’s mothers’ countries of birth (born in Germany vs. foreign-born). Self-reported home language (L1) was used to calculate the average linguistic distance to German as one continuous variable. Results: Mixed-effects models showed that two out of fourteen effects of interest survived the adjustment for known confounders and accounting for the nestedness of data within birth hospitals. Linguistic distance from mothers’ L1s to German was independently associated with diagnoses of preeclampsia (OR = 1.01, 95% CI = [1.00, 1.01]). Infants of foreign-born mothers had higher odds for amniotic infection syndrome (AIS; OR = 1.45 [1.13, 1.86]) than infants of German mothers. Conclusions: Our findings from this large multi-centre longitudinal cohort of VP-born children indicate that maternal immigrant status and language barriers have limited impact on perinatal health and severe neonatal outcomes. This suggests that, regardless of background or language skills, there may be few inequalities in the perinatal health of pregnant women and their newborn preterm infants.

AB - Background: In Germany, more than 40% of infants are born to immigrant parents. Increased survival rates of very preterm (below 32 weeks gestation at birth; VP) infants have not resulted in equally improved life chances and quality of life. More information on perinatal variations in outcomes according to social inequalities, migration background, and language barriers is needed. We tested whether mothers’ immigrant status and language barriers are associated with perinatal health and short-term neonatal outcomes. Methods: The data are from the national multi-centre German Neonatal Network (GNN) cohort, including VP births from 2009 onwards. In total, 3606 (n = 1738 female) children were assessed, and 919 (n = 449 female) of these children had immigrant backgrounds. Immigrant status was operationalised as a binary variable based on the children’s mothers’ countries of birth (born in Germany vs. foreign-born). Self-reported home language (L1) was used to calculate the average linguistic distance to German as one continuous variable. Results: Mixed-effects models showed that two out of fourteen effects of interest survived the adjustment for known confounders and accounting for the nestedness of data within birth hospitals. Linguistic distance from mothers’ L1s to German was independently associated with diagnoses of preeclampsia (OR = 1.01, 95% CI = [1.00, 1.01]). Infants of foreign-born mothers had higher odds for amniotic infection syndrome (AIS; OR = 1.45 [1.13, 1.86]) than infants of German mothers. Conclusions: Our findings from this large multi-centre longitudinal cohort of VP-born children indicate that maternal immigrant status and language barriers have limited impact on perinatal health and severe neonatal outcomes. This suggests that, regardless of background or language skills, there may be few inequalities in the perinatal health of pregnant women and their newborn preterm infants.

KW - immigrants

KW - inequalities

KW - language barriers

KW - perinatal and neonatal health

KW - very preterm birth

UR - http://www.scopus.com/inward/record.url?scp=85196907294&partnerID=8YFLogxK

U2 - 10.3390/healthcare12121211

DO - 10.3390/healthcare12121211

M3 - Journal article

C2 - 38921324

AN - SCOPUS:85196907294

VL - 12

JO - Healthcare

JF - Healthcare

SN - 2227-9032

IS - 12

M1 - 1211

ER -