Birth and postnatal outcomes among infants of immigrant parents of different admission categories and parents born in Canada: a population-based retrospective study

Abstract

Background: Most studies of disparities smallforgestationalage (SGA) and adjusted risk ratio [RR] 1.08, 95% confiin birth and postnatal outcomes by largeforgestationalage (LGA) births, dence interval [CI] 1.01–1.15) and LGA parental birthplace combine all immistillbirths, and infant deaths among birth (9.2% v. 7.5%, adjusted RR 1.12, grants into a single group. We sought to singleton births by group. 95% CI 1.10–1.15), but lower risk of SGA evaluate heterogeneity among immibirth (10.2% v. 11.0%, adjusted RR 0.92, grants in Canada by comparing birth Results: Among 7 980 650 births, 95% CI 0.90–0.94), while infants of and postnatal outcomes across different 1 715 050 (21.5%) were to immigrants, familyclass immigrants had higher risk immigration categories. including 632 760 (36.9%) in the ecoof SGA birth (12.2% v. 11.0%, adjusted nomic class, 853 540 (49.8%) in the famRR 1.01, 95% CI 1.00–1.02). Risk of stillMethods: We conducted a populationily class, and 228 740 (13.4%) refugees. birth, neonatal death, and overall based retrospective study using StatisCompared with infants of Canadianinfant death did not differ significantly tics Canada data on live births and stillborn birthing parents, infants of each among immigrant groups. births (1993–2017) and infant deaths of the 3 immigrant groups had higher (1993–2018), linked to parental immirisk of preterm birth, SGA birth, and Interpretation: Heterogeneity exists in gration data (1960–2017). We classified stillbirth, but lower risk of LGA birth outcomes of infants born to immigrants birthing parents as born in Canada, and neonatal death. Compared with to Canada across immigration categoreconomicclass immigrants, familyinfants of economicclass immigrants, ies. These results highlight the importclass immigrants, or refugees, and infants of refugees had higher risk of ance of disaggregating immigrant popuevaluated differences in preterm births, early preterm birth (0.9% v. 0.8%, lations in studies of health disparities.