Helse i svangerskapet blant innvandrerkvinner i Norge – en utforskende litteraturoversikt

BAKGRUNN Innvandrerkvinner er en sårbar gruppe innen norsk fødselsomsorg med økt risiko for uheldige svangerskapsutfall. Hensikten med denne utforskende litteraturoversikten var å få en oversikt over tilgjengelig kunnskap om helse i svangerskapet blant innvandrerkvinner i Norge. KUNNSKAPSGRUNNLAG Litteraturoversikten inkluderer 44 fagfellevurderte artikler om helse i svangerskapet blant innvandrerkvinner i Norge, med ulike studiedesign og publisert i perioden 2000–19. Søket ble utført i MEDLINE, Embase, Cochrane Library, CINAHL, Psycinfo, Maternity & Infant Care Database og SveMed+. RESULTATER Svangerskapsdiabetes, fedme, svangerskapskvalme, svangerskapsforgiftning og folatbruk var hyppig studerte temaer. Vi fant en betydelig variasjon i sykdomsrisiko for ulike undergrupper av innvandrere. FORTOLKNING Lite forskning er gjort på spesielt sårbare innvandrergrupper, som nyankomne, papirløse og flyktninger. Vi anbefaler at man i fremtidig forskning vurderer kvalitativt studiedesign der innvandrerfamiliers erfaringer blir belyst, samt intervensjonsstudier hvor effekt av tiltak prøves ut.publishedVersio

Risk of Subsequent Preeclampsia by Maternal Country of Birth: A Norwegian Population-Based Study

In this nationwide population-based study, we investigated the associations of preeclampsia in the first pregnancy with the risk of preeclampsia in the second pregnancy, by maternal country of birth using data from the Medical Birth Registry of Norway and Statistics Norway (1990–2016). The study population included 101,066 immigrant and 544,071 non-immigrant women. Maternal country of birth was categorized according to the seven super-regions of the Global Burden of Disease study (GBD). The associations between preeclampsia in the first pregnancy with preeclampsia in the second pregnancy were estimated using log-binomial regression models, using no preeclampsia in the first pregnancy as the reference. The associations were reported as adjusted risk ratios (RR) with 95% confidence intervals (CI), adjusted for chronic hypertension, year of first childbirth, and maternal age at first birth. Compared to those without preeclampsia in the first pregnancy, women with preeclampsia in the first pregnancy were associated with a considerably increased risk of preeclampsia in the second pregnancy in both immigrant (n = 250; 13.4% vs. 1.0%; adjusted RR 12.9 [95% CI: 11.2, 14.9]) and non-immigrant women (n = 2876; 14.6% vs. 1.5%; adjusted RR 9.5 [95% CI: 9.1, 10.0]). Immigrant women from Latin America and the Caribbean appeared to have the highest adjusted RR, followed by immigrant women from North Africa and the Middle East. A likelihood ratio test showed that the variation in adjusted RR across all immigrant and non-immigrant groups was statistically significant (p = 0.006). Our results suggest that the association between preeclampsia in the first pregnancy and preeclampsia in the second pregnancy might be increased in some groups of immigrant women compared with non-immigrant women in Norway.publishedVersio

Pelvic Floor Disorders and Pelvic Floor Muscle Exercise: A Survey on Knowledge, Attitude, and Practice among Pregnant Women in Northwest Ethiopia

The purpose of the study was to investigate 1: overall knowledge of pelvic organ prolapse (POP) and urinary incontinence (UI) as well as knowledge, attitudes, and practice of pelvic floor muscle exercise (PFME); and 2: the association of these factors with parity in pregnant women in Gondar, Ethiopia. A facility-based cross-sectional study was performed in the Central Gondar zone, northwest Ethiopia between February and April 2021. The associations between parity and knowledge of POP and UI, and knowledge, attitude, and practice towards PFME were estimated using logistics regression models and presented as crude and adjusted odds ratios with 95% confidence intervals. Nulliparous women were used as the reference. Adjustments were made for maternal age, antenatal care visits, and level of education. The study sample comprised 502 pregnant women: 133 nulliparous, and 369 multiparous. We found no association between parity and knowledge of POP, UI, or knowledge, attitude, and practice toward PFME. The sum score indicated poor knowledge about both POP, UI, and PFME in the study population, and poor attitude and practice of PFME. Despite a high attendance in antenatal care services, knowledge, attitude, and practice were poor, indicating a need for quality improvement of the services.publishedVersio

Helse i svangerskapet blant innvandrerkvinner i Norge – en utforskende litteraturoversikt

BAKGRUNN Innvandrerkvinner er en sårbar gruppe innen norsk fødselsomsorg med økt risiko for uheldige svangerskapsutfall. Hensikten med denne utforskende litteraturoversikten var å få en oversikt over tilgjengelig kunnskap om helse i svangerskapet blant innvandrerkvinner i Norge. KUNNSKAPSGRUNNLAG Litteraturoversikten inkluderer 44 fagfellevurderte artikler om helse i svangerskapet blant innvandrerkvinner i Norge, med ulike studiedesign og publisert i perioden 2000–19. Søket ble utført i MEDLINE, Embase, Cochrane Library, CINAHL, Psycinfo, Maternity & Infant Care Database og SveMed+. RESULTATER Svangerskapsdiabetes, fedme, svangerskapskvalme, svangerskapsforgiftning og folatbruk var hyppig studerte temaer. Vi fant en betydelig variasjon i sykdomsrisiko for ulike undergrupper av innvandrere. FORTOLKNING Lite forskning er gjort på spesielt sårbare innvandrergrupper, som nyankomne, papirløse og flyktninger. Vi anbefaler at man i fremtidig forskning vurderer kvalitativt studiedesign der innvandrerfamiliers erfaringer blir belyst, samt intervensjonsstudier hvor effekt av tiltak prøves ut

Placental abruption in immigrant women in Norway: a population-based study

Introduction Placental abruption is a serious complication in pregnancy. While its incidence varies across countries, the information of how abruption varies in immigrant populations is limited. The aims of this study were to estimate the incidence of placental abruption in immigrant women compared to non‐immigrants by maternal country and region of birth, reason for immigration and length of residence. Material and methods We conducted a nationwide population‐based study using data from the Medical Birth Registry of Norway and Statistics Norway (1990‐2016). The study sample included 1,558,174 pregnancies, in which immigrant women accounted for 245,887 pregnancies and 1,312,287 pregnancies were to non‐immigrants. Crude and adjusted odds ratios with 95% confidence intervals (CI) for placental abruption in immigrant women compared to non‐immigrants were estimated by logistic regression with robust standard error estimations (accounting for within‐mother clustering). Adjustment variables included year of birth, maternal age, parity, multiple pregnancies, chronic hypertension and level of education. Results The incidence of placental abruption decreased during the study period for both immigrants (from 0.68% to 0.44%) and non‐immigrants (from 0.80% to 0.34%). Immigrant women from the sub‐Saharan African region had an adjusted odds ratio of 1.35 (95% CI: 1.15‐1.58) compared to non‐immigrants for placental abruption, whereas immigrant women from Ethiopia had an adjusted odds ratio of 2.39 (95% CI 1.67‐3.41). We found a small variation in placental abruption incidence by other countries or regions of birth, length of residence and reason for immigration. Conclusions Immigrant women from sub‐Saharan Africa, especially Ethiopia, have increased odds for placental abruption when giving birth in Norway. Reason for immigration and length of residence had little impact on the incidence of placental abruption