{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:50:56Z","timestamp":1791561056490,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T00:00:00Z","timestamp":1646352000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the risk of severe maternal outcomes among migrant women, considering both their legal status and birthplace; in Europe, migrant women, especially from sub\u2010Saharan Africa, have higher risks of adverse maternal outcomes compared with non\u2010migrants and legal status, a component of migrant condition, may be an important, and potentially actionable, risk factor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Four maternity units around Paris in 2010\u201312.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>A total of 9599 women with singleton pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Legal status was categorised in four groups: reference group of non\u2010migrant native Frenchwomen, legal migrants with French or European citizenship, other legal migrants with non\u2010European citizenship, and undocumented migrants. The risk of severe maternal morbidity was assessed with multivariable logistic regression models according to women's legal status and birthplace.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measure<\/jats:title><jats:p>Binary composite criterion of severe maternal morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Undocumented migrants had resided for less time in France, experienced social isolation, linguistic barriers and poor housing conditions more frequently and had a pre\u2010pregnancy medical history at lower risk than other migrants. The multivariable analysis showed that they had a higher risk of severe maternal morbidity than non\u2010migrants (33\/715 [4.6%] versus 129\/4523 [2.9%]; adjusted odds ratio [aOR] 1.68, 95% CI 1.12\u20132.53). This increased risk was significant for undocumented women from sub\u2010Saharan Africa (18\/308 [5.8%] versus 129\/4523 [2.9%]; aOR 2.26, 95% CI 1.30\u20133.91), and not for those born elsewhere (15\/407 [3.7%] versus 129\/4523 [2.9%]; aOR 1.44, 95% CI 0.82\u20132.53).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Undocumented migrants are the migrant subgroup at highest risk of severe maternal morbidity, whereas the prevalence of risk factors does not appear to be higher in this subgroup. This finding suggests that their interaction with maternity care services may be sub\u2010optimal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Undocumented migrants, especially those born in sub\u2010Saharan Africa, have the highest risk of Severe Maternal Morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17124","type":"journal-article","created":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T17:27:49Z","timestamp":1644859669000},"page":"1762-1771","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Severe maternal morbidity among undocumented migrant women in the PreCARE prospective cohort study"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8465-2481","authenticated-orcid":false,"given":"Maxime","family":"Eslier","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Paris, CRESS, Obstetric Perinatal and Paediatric Epidemiology Research Team, EPOP\u00e9, INSERM, INRA  Paris France"},{"name":"Department of Obstetrics and Gynaecology Caen Hospital  Caen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6561-3321","authenticated-orcid":false,"given":"Catherine","family":"Deneux\u2010Tharaux","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, CRESS, Obstetric Perinatal and Paediatric Epidemiology Research Team, EPOP\u00e9, INSERM, INRA  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1014-6655","authenticated-orcid":false,"given":"Priscille","family":"Sauvegrain","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, CRESS, Obstetric Perinatal and Paediatric Epidemiology Research Team, EPOP\u00e9, INSERM, INRA  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, CRESS, Obstetric Perinatal and Paediatric Epidemiology Research Team, EPOP\u00e9, INSERM, INRA  Paris France"},{"name":"Department of Obstetrics and Gynaecology Robert Debr\u00e9 Hospital  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Luton","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Beaujon\u2010Bichat Hospital, FHU PREMA  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5883-7597","authenticated-orcid":false,"given":"Laurent","family":"Mandelbrot","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Louis Mourier Hospital, FHU PREMA  Colombes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candice","family":"Estellat","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Public Health and Medical Information Clinical Research Unit, Pharmacoepidemiology Center (C\u00e9ph\u00e9pi) Sorbonne University INSERM UMR\u2010S 1136 \u2010 Pierre Louis Institute of Epidemiology and Public Health  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6159-6253","authenticated-orcid":false,"given":"Elie","family":"Azria","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, CRESS, Obstetric Perinatal and Paediatric Epidemiology Research Team, EPOP\u00e9, INSERM, INRA  Paris France"},{"name":"Maternity Unit Paris Saint Joseph Hospital, FHU PREMA  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,4]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Les immigr\u00e9s r\u00e9cemment arriv\u00e9s en France [Recent immigrants to France] \u2010 Insee Premi\u00e8re \u2010 1524. 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