PhD student: Maxime Eslier
Title: Severe maternal morbidity in migrant women in countries with high health standards.
Supervisors: Elie Azria, Catherine Deneux-Tharaux
Doctoral school: ED 393 Epidemiology and Biomedical Information Sciences, Université Paris Cité
In high-income countries, migrants represent 15% of the population, and more than a quarter are women of childbearing age. In France, one in four births is to a migrant woman. Although an increased risk of severe maternal outcomes among migrant women has been reported, the international literature assessing this association is heterogeneous, and their mechanisms are incompletely understood.
The first part of this thesis, based on a systematic review of the literature in high-income countries, showed that the risk of maternal mortality and severe maternal morbidity in migrant women compared with native-born women varies by host country and region of birth. The subsequent parts of the thesis explored two possible mechanisms for this higher risk of severe maternal outcomes among migrant women, through analyses of data from the French PreCARE cohort: legal status and language barrier. The first analysis found that, compared with migrant women with no language barrier, those with partial or total language barrier have a higher risk of inadequate prenatal care utilization. The second analysis found an increased risk of severe maternal morbidity among undocumented migrants compared with non-migrants.
These results highlight the importance of not considering migrant women as a homogeneous group, but of taking into account some of their individual characteristics in order to characterize their risks and needs. They have identified potentially modifiable risk factors, for consideration in terms of health policies.
Migrants, health inequalities, maternal mortality, severe maternal morbidity, inadequate prenatal care utilization, legal status, undocumented migrant, linguistic barrier