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Preconception health among migrant women in England: a cross-sectional analysis of maternity services data 2018-2019

Preconception health among migrant women in England: a cross-sectional analysis of maternity services data 2018-2019
Preconception health among migrant women in England: a cross-sectional analysis of maternity services data 2018-2019
Objective: to examine inequalities in preconception health between migrant women in potentially vulnerable situations and non-migrant women.

Design: national cross-sectional study.

Setting: data from the National Health Service (NHS) Maternity Services Data Set (MSDS) version 1.5, using data submitted by NHS maternity services in England.

Participants: all 652,880 women with an antenatal booking appointment between 1/4/2018 and 31/3/2019 were included. Data regarding migration status were available for 66.2% of the study population (n=432,022).

Outcome measures: prevalence of preconception indicators were compared between probable migrants (those with complex social factors and English not their first language), possible migrants due to English not being a first language (without complex social factors), possible migrants due to complex social factors (who speak English as their first language) and unlikely migrants (those who speak English as their first language without complex social factors). Complex social factors include recent migrants, asylum seekers or refugees, difficulty reading or speaking English; alcohol and/or drugs misuse; all those aged under 20; and/or experiencing domestic abuse. Odds ratios were calculated comparing preconception indicators among those identified as migrants compared to unlikely migrants.

Results: women identified as probable migrants (n=25,070) had over twice the odds of not taking folic acid before pregnancy and of having their first antenatal booking appointment after the recommended 10 weeks gestation compared to unlikely migrants (n=303,737), after adjusting for area-based deprivation level, mother’s age at booking, number of previous live births and ethnicity (odds ratio 2.15 (95% confidence interval 2.06 to 2.25) and 2.25 (2.18 to 2.32) respectively). Probable migrants had increased odds of previous obstetric complications and being underweight at booking, but lower odds of recorded physical and mental health conditions (apart from diabetes and hepatitis b), smoking and obesity in unadjusted and adjusted analyses.

Conclusions: inequalities between migrant women in potentially vulnerable situations and non-migrants exist across many preconception indicators. Findings highlight the opportunity to improve preconception health in this population in order to reduce health inequalities and improve perinatal and neonatal outcomes.
McGranahan, Majel
3342167a-d806-4fa5-bad5-5d0c5791359c
Augarde, Elizabeth
7858b770-e36f-46ab-b410-4f42a2177e7d
Schoenaker, Danielle
84b96b87-4070-45a5-9777-5a1e4e45e818
Duncan, Helen
f9117d83-10bf-487c-b953-e3a8f21f7417
Mann, Sue
364e6782-e510-426b-a623-0f9e60119986
Bick, Debra
18ec34f3-7e1b-47c6-a6e2-949a00bac1c6
Boardman, Felicity
5d93181d-50f3-4adf-9efc-fa7a9faff9d0
Oyebode, Oyinlola
f54b2c1a-6836-4774-b258-67cec53ae26e
McGranahan, Majel
3342167a-d806-4fa5-bad5-5d0c5791359c
Augarde, Elizabeth
7858b770-e36f-46ab-b410-4f42a2177e7d
Schoenaker, Danielle
84b96b87-4070-45a5-9777-5a1e4e45e818
Duncan, Helen
f9117d83-10bf-487c-b953-e3a8f21f7417
Mann, Sue
364e6782-e510-426b-a623-0f9e60119986
Bick, Debra
18ec34f3-7e1b-47c6-a6e2-949a00bac1c6
Boardman, Felicity
5d93181d-50f3-4adf-9efc-fa7a9faff9d0
Oyebode, Oyinlola
f54b2c1a-6836-4774-b258-67cec53ae26e

[Unknown type: UNSPECIFIED]

Record type: UNSPECIFIED

Abstract

Objective: to examine inequalities in preconception health between migrant women in potentially vulnerable situations and non-migrant women.

Design: national cross-sectional study.

Setting: data from the National Health Service (NHS) Maternity Services Data Set (MSDS) version 1.5, using data submitted by NHS maternity services in England.

Participants: all 652,880 women with an antenatal booking appointment between 1/4/2018 and 31/3/2019 were included. Data regarding migration status were available for 66.2% of the study population (n=432,022).

Outcome measures: prevalence of preconception indicators were compared between probable migrants (those with complex social factors and English not their first language), possible migrants due to English not being a first language (without complex social factors), possible migrants due to complex social factors (who speak English as their first language) and unlikely migrants (those who speak English as their first language without complex social factors). Complex social factors include recent migrants, asylum seekers or refugees, difficulty reading or speaking English; alcohol and/or drugs misuse; all those aged under 20; and/or experiencing domestic abuse. Odds ratios were calculated comparing preconception indicators among those identified as migrants compared to unlikely migrants.

Results: women identified as probable migrants (n=25,070) had over twice the odds of not taking folic acid before pregnancy and of having their first antenatal booking appointment after the recommended 10 weeks gestation compared to unlikely migrants (n=303,737), after adjusting for area-based deprivation level, mother’s age at booking, number of previous live births and ethnicity (odds ratio 2.15 (95% confidence interval 2.06 to 2.25) and 2.25 (2.18 to 2.32) respectively). Probable migrants had increased odds of previous obstetric complications and being underweight at booking, but lower odds of recorded physical and mental health conditions (apart from diabetes and hepatitis b), smoking and obesity in unadjusted and adjusted analyses.

Conclusions: inequalities between migrant women in potentially vulnerable situations and non-migrants exist across many preconception indicators. Findings highlight the opportunity to improve preconception health in this population in order to reduce health inequalities and improve perinatal and neonatal outcomes.

UNSPECIFIED
2023.01.26.23284338v1.full - Author's Original
Available under License Creative Commons Attribution.
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Published date: 28 January 2023

Identifiers

Local EPrints ID: 475532
URI: http://eprints.soton.ac.uk/id/eprint/475532
PURE UUID: 52c84ac7-a83f-4605-b9bf-3fbd63cab9c3
ORCID for Danielle Schoenaker: ORCID iD orcid.org/0000-0002-7652-990X

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Date deposited: 21 Mar 2023 17:37
Last modified: 13 Sep 2023 01:58

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Contributors

Author: Majel McGranahan
Author: Elizabeth Augarde
Author: Helen Duncan
Author: Sue Mann
Author: Debra Bick
Author: Felicity Boardman
Author: Oyinlola Oyebode

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