Measuring the invisible: perinatal health outcomes of unregistered women giving birth in Belgium, a population-based study
Abstract Background The unregistered population remains under-researched because of its “invisible” status in statistics. Studies on perinatal health outcomes of unregistered women remains particularly limited. Our objectives were 1) to describe the sociodemographic profiles of women who are not leg...
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-021-04183-9 |
| _version_ | 1819114521729433600 |
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| author | Claudia Schoenborn Myriam De Spiegelaere Judith Racape |
| author_facet | Claudia Schoenborn Myriam De Spiegelaere Judith Racape |
| author_sort | Claudia Schoenborn |
| collection | DOAJ |
| description | Abstract Background The unregistered population remains under-researched because of its “invisible” status in statistics. Studies on perinatal health outcomes of unregistered women remains particularly limited. Our objectives were 1) to describe the sociodemographic profiles of women who are not legally residing in Belgium and 2) to analyze the associations of registration status with pregnancy outcomes according to socioeconomic status and nationality. Methods We analysed data from birth and death certificates taken from the Belgian civil registration system, linked with the National Population Registry (NPR). The data relates to all singleton babies born between 2010 and 2016 (n = 871,283), independent of their mother’s NPR registration status. We used logistic regression to estimate the odds ratios for the associations between perinatal outcomes (perinatal mortality, prematurity and low birth weight) and maternal NPR registration status according to socioeconomic status and maternal nationality. Results Over the study period, 1.9% of births were to mothers without NPR-registration. Unregistered women from newer EU member states and non-European countries were particularly disadvantaged from a socioeconomic point of view. Apart from women with a South American nationality, all other groups of unregistered women had higher rates of prematurity, low birth weight, and perinatal mortality, compared to registered mothers (p < 0.0001). Unregistered women from Belgium and EU15 nationalities had particularly higher rates of prematurity, low birth weight, and perinatal mortality, compared to registered mothers, even after adjustment for socioeconomic status (p < 0.0001). The excess of perinatal mortality for non-European unregistered mothers could partly be explained by their precarious socioeconomic situation. Conclusions This is the first study to include data on mothers who were not legally residing in Belgium. Unregistered women giving birth in Belgium are likely a heterogeneous socioeconomic group. Overall, unregistered women have increased risks of adverse perinatal outcomes, but it is likely that the causal mechanisms differ starkly between Belgian, European and non-European women. Further research is needed to understand the mechanisms behind these accrued rates. It is important to keep measuring the health outcomes of the populations which are “invisible” in national statistics, in order to identify the groups in most need of integration and access to services. |
| first_indexed | 2024-12-22T04:46:37Z |
| format | Article |
| id | doaj.art-21ab2437e4a14939865610185376a573 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-22T04:46:37Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-21ab2437e4a14939865610185376a5732022-12-21T18:38:35ZengBMCBMC Pregnancy and Childbirth1471-23932021-10-0121111310.1186/s12884-021-04183-9Measuring the invisible: perinatal health outcomes of unregistered women giving birth in Belgium, a population-based studyClaudia Schoenborn0Myriam De Spiegelaere1Judith Racape2Research centre in Social Approaches to Health, School of Public Health, Université libre de Bruxelles (ULB)Research centre in Social Approaches to Health, School of Public Health, Université libre de Bruxelles (ULB)Research centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB)Abstract Background The unregistered population remains under-researched because of its “invisible” status in statistics. Studies on perinatal health outcomes of unregistered women remains particularly limited. Our objectives were 1) to describe the sociodemographic profiles of women who are not legally residing in Belgium and 2) to analyze the associations of registration status with pregnancy outcomes according to socioeconomic status and nationality. Methods We analysed data from birth and death certificates taken from the Belgian civil registration system, linked with the National Population Registry (NPR). The data relates to all singleton babies born between 2010 and 2016 (n = 871,283), independent of their mother’s NPR registration status. We used logistic regression to estimate the odds ratios for the associations between perinatal outcomes (perinatal mortality, prematurity and low birth weight) and maternal NPR registration status according to socioeconomic status and maternal nationality. Results Over the study period, 1.9% of births were to mothers without NPR-registration. Unregistered women from newer EU member states and non-European countries were particularly disadvantaged from a socioeconomic point of view. Apart from women with a South American nationality, all other groups of unregistered women had higher rates of prematurity, low birth weight, and perinatal mortality, compared to registered mothers (p < 0.0001). Unregistered women from Belgium and EU15 nationalities had particularly higher rates of prematurity, low birth weight, and perinatal mortality, compared to registered mothers, even after adjustment for socioeconomic status (p < 0.0001). The excess of perinatal mortality for non-European unregistered mothers could partly be explained by their precarious socioeconomic situation. Conclusions This is the first study to include data on mothers who were not legally residing in Belgium. Unregistered women giving birth in Belgium are likely a heterogeneous socioeconomic group. Overall, unregistered women have increased risks of adverse perinatal outcomes, but it is likely that the causal mechanisms differ starkly between Belgian, European and non-European women. Further research is needed to understand the mechanisms behind these accrued rates. It is important to keep measuring the health outcomes of the populations which are “invisible” in national statistics, in order to identify the groups in most need of integration and access to services.https://doi.org/10.1186/s12884-021-04183-9Perinatal healthHealth inequalitiesUndocumented migrantsSocioeconomic statusVital statisticsUnregistered population |
| spellingShingle | Claudia Schoenborn Myriam De Spiegelaere Judith Racape Measuring the invisible: perinatal health outcomes of unregistered women giving birth in Belgium, a population-based study BMC Pregnancy and Childbirth Perinatal health Health inequalities Undocumented migrants Socioeconomic status Vital statistics Unregistered population |
| title | Measuring the invisible: perinatal health outcomes of unregistered women giving birth in Belgium, a population-based study |
| title_full | Measuring the invisible: perinatal health outcomes of unregistered women giving birth in Belgium, a population-based study |
| title_fullStr | Measuring the invisible: perinatal health outcomes of unregistered women giving birth in Belgium, a population-based study |
| title_full_unstemmed | Measuring the invisible: perinatal health outcomes of unregistered women giving birth in Belgium, a population-based study |
| title_short | Measuring the invisible: perinatal health outcomes of unregistered women giving birth in Belgium, a population-based study |
| title_sort | measuring the invisible perinatal health outcomes of unregistered women giving birth in belgium a population based study |
| topic | Perinatal health Health inequalities Undocumented migrants Socioeconomic status Vital statistics Unregistered population |
| url | https://doi.org/10.1186/s12884-021-04183-9 |
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