{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:36:12Z","timestamp":1790703372428,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T00:00:00Z","timestamp":1623888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study aims to explore maternal and perinatal outcomes of migrant women in Iceland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This prospective population\u2010based cohort study included women who gave birth to a singleton in Iceland between 1997 and 2018, comprising a total of 92\u00a0403 births. Migrant women were defined as women with citizenship other than Icelandic, including refugees and asylum seekers, and categorized into three groups, based on their country of citizenship Human Development Index score. The effect of country of citizenship was estimated. The main outcome measures were onset of labor, augmentation, epidural, perineum support, episiotomy, mode of birth, obstetric anal sphincter injury, postpartum hemorrhage, preterm birth, a 5\u2010minute Apgar &lt;7, neonatal intensive care unit admission and perinatal mortality. Odds ratios (ORs) and 95% confidence intervals (CIs) for maternal and perinatal outcomes were calculated using logistic regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 8158 migrant women gave birth during the study period: 4401 primiparous and 3757 multiparous. Overall, migrant women had higher adjusted ORs (aORs) for episiotomy (primiparas: aOR 1.43, 95% CI 1.26\u20131.61; multiparas: 1.39, 95% CI 1.21\u20131.60) and instrumental births (primiparas: 1.14, 95% CI 1.02\u20131.27, multiparas: 1.41, 95% CI 1.16\u20131.72) and lower aORs of induction of labor (primiparas: 0.88, 95% CI 0.79\u20130.98; multiparas: 0.74, 95% CI 0.66\u20130.83), compared with Icelandic women. Migrant women from countries with a high Human Development Index score (\u22650.900) had similar or better outcomes compared with Icelandic women, whereas migrant women from countries with a lower Human Development Index score than that of Iceland (&lt;0.900) had additionally increased odds of maternal and perinatal complications and interventions, such as emergency cesarean and postpartum hemorrhage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women\u2019s citizenship and country of citizenship Human Development Index scores are significantly associated with a range of maternal and perinatal complications and interventions, such as episiotomy and instrumental birth. The results indicate the need for further exploration of whether Icelandic perinatal healthcare services meet the care needs of migrant women.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14186","type":"journal-article","created":{"date-parts":[[2021,5,22]],"date-time":"2021-05-22T16:39:55Z","timestamp":1621701595000},"page":"1665-1677","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Challenges in migrant women\u2019s maternity care in a high\u2010income country: A population\u2010based cohort study of maternal and perinatal outcomes"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9967-1442","authenticated-orcid":false,"given":"Embla \u00ddr","family":"Gu\u00f0mundsd\u00f3ttir","sequence":"first","affiliation":[{"name":"Department of Midwifery Faculty of Nursing University of Iceland Reykjav\u00edk Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helga","family":"Gottfre\u00f0sd\u00f3ttir","sequence":"additional","affiliation":[{"name":"Department of Midwifery Faculty of Nursing University of Iceland Reykjav\u00edk Iceland"},{"name":"Department of Obstetrics and Gynecology Women\u2019s Clinic Landsp\u00edtali University Hospital Reykjav\u00edk Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berglind","family":"H\u00e1lfd\u00e1nsd\u00f3ttir","sequence":"additional","affiliation":[{"name":"Department of Midwifery Faculty of Nursing University of Iceland Reykjav\u00edk Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Nieuwenhuijze","sequence":"additional","affiliation":[{"name":"Research Center for Midwifery Science Academie Verloskunde Maastricht Zuyd the Netherlands"},{"name":"CAPHRI School for Public Health and Primary Care Maastricht University Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Information Services Department Finnish Institute for Health and Welfare Helsinki Finland"},{"name":"Division of Family Medicine and Primary Care Department of Neurobiology, Care Sciences and Society Karolinska Institute Stockholm Sweden"},{"name":"Research Center for Child Psychiatry University of Turku Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4931-7650","authenticated-orcid":false,"given":"Kristjana","family":"Einarsd\u00f3ttir","sequence":"additional","affiliation":[{"name":"Center of Public Health Sciences Faculty of Medicine University of Iceland Reykjav\u00edk Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,17]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"World Health Organization.Report on the health of refugees and migrants in the WHO European Region: No public health without refugee and migrant health. 2018. 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