DÄ internationalArchive26/2018Migration Background Should Be Considered
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A substantial proportion of pregnant women in the maternity facilities in large German cities and conurbations have a migration background. In order to ensure that high quality healthcare can be delivered, it is important to consider this fact when discussing overweight and pregnancy risks.

In a study funded by the German Research Foundation (DFG), we investigated peripartum health outcomes in 7100 pregnant women at three large maternity hospitals in Berlin, whose parturition course we followed prospectively (1, 2). Induced births were more common in overweight and obese women, but no differences were seen between women with and without a migration background. Similarly, in the context of secondary cesarean sections, we observed an association only with overweight, not with a migration background. This indicates that peripartum care and support are of a high quality (1, 2).

We used Cox regression models to compare rates of large-for-gestational-age (LGA) neonates, small-for-gestational-age (SGA) neonates, and premature babies. A total of 2586 women with a migration background were included, the largest subgroups were from Turkey and Lebanon. The comparison group consisted of 2676 women without a migration background. Of the women of Turkish origin, 53.6% were overweight or obese; compared to 33.4% of the women without a migration background. The greatest risks were seen for LGA babies, both in women with and without a migration background. SGA babies were less frequent in the group of overweight women. The attributable risks (proportion of preventable cases in the population under study) for LGA neonates, preterm births, and extreme preterm births were 16.3%, 3.6%, and 16.5%, respectively (3). In the group of women with a migration background, the attributable risks owing to overweight/obesity were thus higher than those due to smoking (3). Women with a migration background therefore require particular attention with regard to the risk factor overweight.

DOI: 10.3238/arztebl.2018.0453b

Prof. Dr. med. Oliver Razum

Abteilung Epidemiologie und International Public Health

Fakultät für Gesundheitswissenschaften

Universität Bielefeld, oliver.razum@uni-bielefeld.de

Prof. Dr. med. Matthias David

Charité Berlin, Campus Virchow-Klinikum

Klinik für Gynäkologie

Conflict of interest statement

The authors declare that no conflict of interest exists.

1.
Reiss K, Breckenkamp J, Borde T, et al.: The association of pre-pregnancy overweight and obesity with delivery outcomes: a comparison of immigrant and non-immigrant women in Berlin, Germany. Int J Public Health 2016; 61: 455–63 CrossRef MEDLINE
2.
David M, Borde T, Brenne S, Henrich W, Breckenkamp J, Razum O: Caesarean section frequency among immigrants, second- and third-generation women, and non-immigrants: prospective study in Berlin/Germany. PLoS ONE 2015; 10: e0127489 CrossRef MEDLINE PubMed Central
3.
Reiss K, Breckenkamp J, Borde T, Brenne S, David M, Razum O: Contribution of overweight and obesity to adverse pregnancy outcomes among immigrant and non-immigrant women in Berlin, Germany. Eur J Public Health 2015; 25: 839–44 CrossRef MEDLINE
4.
Stubert J, Reister F, Hartmann S, Janni W: The risks associated with obesity in pregnancy. Dtsch Arztebl Int 2018; 115: 276–83 VOLLTEXT
1.Reiss K, Breckenkamp J, Borde T, et al.: The association of pre-pregnancy overweight and obesity with delivery outcomes: a comparison of immigrant and non-immigrant women in Berlin, Germany. Int J Public Health 2016; 61: 455–63 CrossRef MEDLINE
2.David M, Borde T, Brenne S, Henrich W, Breckenkamp J, Razum O: Caesarean section frequency among immigrants, second- and third-generation women, and non-immigrants: prospective study in Berlin/Germany. PLoS ONE 2015; 10: e0127489 CrossRef MEDLINE PubMed Central
3. Reiss K, Breckenkamp J, Borde T, Brenne S, David M, Razum O: Contribution of overweight and obesity to adverse pregnancy outcomes among immigrant and non-immigrant women in Berlin, Germany. Eur J Public Health 2015; 25: 839–44 CrossRef MEDLINE
4.Stubert J, Reister F, Hartmann S, Janni W: The risks associated with obesity in pregnancy. Dtsch Arztebl Int 2018; 115: 276–83 VOLLTEXT

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