Adverse perinatal outcomes among children in Switzerland: the impact of national origin and socio-economic group
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ORIGINAL ARTICLE
Adverse perinatal outcomes among children in Switzerland: the impact of national origin and socio-economic group Philippe Wanner1 Received: 9 June 2020 / Revised: 14 September 2020 / Accepted: 20 September 2020 The Author(s) 2020
Abstract Objectives We examined the effect of the mother’s origin and socio-economic characteristics on adverse perinatal outcomes in Switzerland. Methods Births occurring from 2011 to 2017 were identified in the Swiss population register and merged with the Swiss civil register and the Register of the first pillar to obtain information on the migration origin and socio-economic level. Four indicators of adverse perinatal outcomes were defined. Results Logistic regressions show that both the migration origin and the socio-economic level are measured by the parents’ income, influence risk. Compared to the children of mothers born in Switzerland, those of mothers from EU/EFTA countries have a lower risk of infant mortality, low birth weight and extreme prematurity. The highest risk is observed for children born to mothers from the rest of the world. High levels of risk consistently characterize children with low-income parents (first decile). Conclusions Our results justify further investigations at the level of health services to better identify the factors causing differences in the prevalence of adverse outcomes and to take them into account in adapted health policies. Keywords Infant mortality Low birth weight Preterm birth Migrants’ children Health inequalities Switzerland
Introduction Switzerland has one of the highest levels of life expectancy at birth in the world. In 2017, according to the WHO Global Health Observatory (2020), it ranked second behind Hong Kong (81.7 years) for men and seventh for women (85.7 years). Paradoxically, in the same year, Switzerland was ranked 32nd in the world in terms of infant mortality, with an infant death rate per 1000 births higher than the EU average (3.7% compared to 3.3%) and higher than that of all its neighbouring countries (Italy 2.7%, Austria 2.9%, Germany 3.2% and France 3.4%—WHO 2020). Over the past decades, the level of this indicator has also fallen more Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00038-020-01492-2) contains supplementary material, which is available to authorized users. & Philippe Wanner [email protected] 1
Institute of Demography and Socioeconomics, NCCR – on the Move, University of Geneva, Geneva, Switzerland
slowly than that in neighbouring countries (between 2000 and 2017, a decrease of 21%, compared to 23–43% in the four neighbouring countries). The percentage of lowweight (\ 2500 g) births has been estimated as 6.5% (Blencowe et al. 2019), a value that is average for industrialized countries. However, this value has increased by half a point since 2000. The percentage of preterm live births (22–36 weeks) was 7.2% in 2015, which is close to that of neighbouring countries (Euro Pe
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