Background
Methods
Design
Study setting and sample
Exposure
Outcomes
Other variables of interest
Statistical analyses
Migrant women | Swedish-born women | |||||||
---|---|---|---|---|---|---|---|---|
CBD support (n = 880) | No CBD support (n = 16,789) | (n = 129,706) | ||||||
n | % | n | % | pa | n | % | pa | |
Socioeconomic background | ||||||||
Age (years) | < 0.0001 | < 0.0001 | ||||||
< 25 | 213 | 24.2 | 2829 | 16.9 | 15,757 | 12.1 | ||
25–34 | 520 | 59.1 | 10,319 | 61.5 | 85,585 | 66.0 | ||
≥ 35 | 147 | 16.7 | 3641 | 21.7 | 28,364 | 21.9 | ||
Marital status | < 0.0001 | < 0.0001 | ||||||
Married/cohabiting | 621 | 71.6 | 14,251 | 87.4 | 115,804 | 94.4 | ||
Single | 91 | 10.5 | 751 | 4.6 | 2169 | 1.8 | ||
Other | 155 | 17.9 | 1302 | 8 | 4756 | 3.9 | ||
Level of education | < 0.0001 | < 0.0001 | ||||||
Not completed compulsory schoolingb (< 9 years) | 255 | 37.4 | 2696 | 17.6 | 245 | 0.2 | ||
Compulsory schooling (9 years) | 101 | 14.8 | 1761 | 11.5 | 8317 | 6.4 | ||
Upper secondary school (11–12 years) | 143 | 21.0 | 4910 | 32.1 | 46,135 | 35.7 | ||
Post-secondary education (vocational qualification & university) | 183 | 26.8 | 5943 | 38.8 | 74,617 | 57.7 | ||
Mother’s income | < 0.0001 | < 0.0001 | ||||||
≤ 25 percentile | 754 | 89.5 | 10,369 | 63.2 | 25,687 | 19.8 | ||
25–75 percentile | 82 | 9.7 | 4922 | 29.4 | 68,547 | 52.9 | ||
≥ 75 percentile | 6 | 0.7 | 1461 | 8.7 | 35,362 | 27.3 | ||
Migration | ||||||||
Region of birth | < 0.0001 | |||||||
Sub-Saharan Africa | 392 | 44.6 | 3595 | 21.4 | ||||
North Africa & Middle East | 396 | 45.1 | 8348 | 49.7 | ||||
Central Europe Eastern Europe & Central Asia | 76 | 8.6 | 3283 | 19.6 | ||||
South and East Asia & Oceania | 10 | 1.1 | 1241 | 7.4 | ||||
Other | 5 | 0.6 | 322 | 1.9 | ||||
Reason for immigration | < 0.0001 | |||||||
Work/education | 14 | 1.7 | 325 | 2.1 | ||||
Refugee | 301 | 36.4 | 4817 | 30.9 | ||||
Family reunion | 472 | 57.1 | 8215 | 52.7 | ||||
Other | 39 | 4.7 | 2241 | 14.4 | ||||
Length of Residence | < 0.0001 | |||||||
< 2 years | 347 | 41.2 | 2966 | 17.7 | ||||
2–5 years | 319 | 37.9 | 3741 | 22.3 | ||||
6–9 years | 139 | 16.5 | 3186 | 19.0 | ||||
≥10 years | 37 | 4.4 | 6885 | 41.0 | ||||
Obstetric history | ||||||||
Previous caesarean section | 98 | 12.9 | 1872 | 11.7 | 0.287 | 11,221 | 8.7 | < 0.0001 |
Previous stillbirth | 21 | 2.4 | 260 | 1.5 | 0.053 | 805 | 0.6 | < 0.0001 |
Present pregnancy | ||||||||
Parity | < 0.05 | < 0.05 | ||||||
Nulliparous | 379 | 43.1 | 6440 | 38.4 | 61,459 | 47.4 | ||
Parous | 500 | 56.9 | 10,349 | 61.6 | 68,247 | 52.6 | ||
Smoking in early pregnancy | 19 | 2.2 | 906 | 5.6 | < 0.0001 | 7583 | 6.2 | < 0.0001 |
Chronic hypertension | 0 | 0 | 41 | 0.2 | 0.142 | 516 | 0.4 | 0.061 |
Diabetes Mellitus type 1 or 2 | 3 | 0.3 | 72 | 0.4 | 0.696 | 884 | 0.7 | 0.220 |
Gestational diabetes | 12 | 1.4 | 414 | 2.5 | < 0.05 | 1104 | 0.9 | 0.100 |
Pre-eclampsia/eclampsia | 18 | 2.0 | 418 | 2.5 | 0.408 | 4059 | 3.1 | 0.065 |
Pre-pregnancy BMI (kg/m2) | < 0.0001 | < 0.0001 | ||||||
Underweight (< 18.5) | 24 | 2.9 | 425 | 2.8 | 2354 | 2 | ||
Normal weight (18.5–24.9) | 353 | 42.6 | 7904 | 51.5 | 73,085 | 62.6 | ||
Overweight (25.0-29.9) | 268 | 32.3 | 4676 | 30.5 | 27,953 | 24 | ||
Obesity (≥ 30) | 184 | 22.2 | 2334 | 15.2 | 13,317 | 11.4 | ||
Antenatal care visits (No) | < 0.001 | < 0.0001 | ||||||
< 8 | 115 | 13.2 | 2963 | 18.1 | 21,997 | 17.0 | ||
8–12 | 544 | 62.7 | 10,132 | 62 | 82,289 | 66.6 | ||
> 12 | 209 | 24.1 | 3258 | 19.9 | 19,334 | 15.6 | ||
Gestational weeks (gwks) | < 0.0001 | < 0.0001 | ||||||
Preterm < 37 | 19 | 2.2 | 942 | 5.6 | 7278 | 5.6 | ||
Term 37–41 | 714 | 81.1 | 14,433 | 86.0 | 112,678 | 86.9 | ||
Post-term ≥ 42 | 147 | 16.7 | 1410 | 8.4 | 9740 | 7.5 | ||
Birth weight, (grams) | < 0.05 | 0.013 | ||||||
≤ 2500 | 26 | 3.0 | 888 | 5.3 | 4865 | 3.8 | ||
2501–4500 | 834 | 94.8 | 15,566 | 92.8 | 119,528 | 92.2 | ||
> 4500 | 20 | 2.3 | 319 | 1.9 | 5210 | 4.0 |
Results
Migrant women with CBD | Migrant womenen without CBD | |||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n = 379 | n = 6440 | |||||||||||||||||||||
n | % | n | % | OR | CI 95% | adjORa | CI 95% | adjORb | CI 95% | adjORc | CI 95% | |||||||||||
Births to nulliparous women | ||||||||||||||||||||||
Outcome | ||||||||||||||||||||||
Induction of labour | 72 | 19.0 | 890 | 13.8 | 1.46 | 1.12–1.91 | 1.26 | 0.96–1.65 | 1.23 | 0.93–1.61 | 1.16 | 0.88–1.55 | ||||||||||
Epidural analgesia | 107 | 28.2 | 3760 | 39.6 | 0.60 | 0.48–0.76 | 0.61 | 0.48–0.77 | 0.61 | 0.48–0.77 | 0.64 | 0.50–0.81 | ||||||||||
Nitrous oxide | 281 | 74.1 | 5069 | 78.7 | 0.78 | 0.61–0.98 | 0.79 | 0.62-1.00 | 0.79 | 0.62–1.01 | 0.79 | 0.62–1.02 | ||||||||||
Bath | 25 | 6.6 | 757 | 11.8 | 0.53 | 0.35–0.80 | 0.56 | 0.37–0.85 | 0.57 | 0.38–0.87 | 0.64 | 0.42–0.98 | ||||||||||
Non-instrumental vaginal birthd | 267 | 70.4 | 4541 | 70.5 | 1.00 | 0.79–1.25 | 0.94 | 0.74–1.19 | 0.95 | 0.75–1.21 | 0.95 | 0.75–1.21 | ||||||||||
Instrumental vaginal¹ | 34 | 9.0 | 596 | 9.3 | 1.04 | 0.73–1.46 | 1.12 | 0.79–1.58 | 1.11 | 0.79–1.59 | 0.99 | 0.70–1.43 | ||||||||||
Emergency caesarean | 67 | 17.7 | 972 | 15.1 | 1.21 | 0.92–1.59 | 1.20 | 0.91–1.58 | 1.17 | 0.88–1.55 | 1.21 | 0.91–1.61 | ||||||||||
Perineal injury 3rd and 4th degree | 6 | 1.6 | 155 | 2.4 | 0.65 | 0.29–1.48 | 0.73 | 0.32–1.68 | 0.74 | 0.32–1.69 | 0.59 | 0.25–1.39 | ||||||||||
Apgar score < 7 at 5 minutes | 9 | 2.4 | 112 | 1.8 | 1.37 | 0.69–2.72 | 1.28 | 0.64–2.58 | 1.26 | 0.62–2.53 | 1.26 | 0.62–2.57 | ||||||||||
Hospital stay (mother) after birth > 2 days | 206 | 54.9 | 3269 | 50.9 | 1.18 | 0.95–1.45 | 1.12 | 0.90–1.38 | 1.11 | 0.89–1.37 | 1.09 | 0.87–1.36 | ||||||||||
n = 500 | n = 10,349 | Births to parous women | ||||||||||||||||||||
Induction of labour | 89 | 17.8 | 1200 | 11.6 | 1.65 | 1.30–2.09 | 1.49 | 1.17–1.90 | 1.43 | 1.12–1.83 | 1.38 | 1.08–1.76 | ||||||||||
Epidural analgesia | 39 | 7.8 | 1212 | 11.7 | 0.64 | 0.46–0.89 | 0.63 | 0.45–0.88 | 0.64 | 0.46–0.89 | 0.80 | 0.57–1.13 | ||||||||||
Nitrous oxide | 321 | 64.2 | 7026 | 67.9 | 0.85 | 0.70–1.02 | 0.85 | 0.70–1.02 | 0.85 | 0.70–1.03 | 0.89 | 0.73–1.08 | ||||||||||
Bath | 16 | 3.2 | 339 | 3.3 | 0.98 | 0.59–1.63 | 1.02 | 0.61–1.71 | 1.08 | 0.65–1.82 | 1.25 | 0.74–2.11 | ||||||||||
Non-instrumental vaginal birthd | 428 | 85.6 | 8603 | 83.1 | 1.21 | 0.94–1.56 | 1.15 | 0.89–1.49 | 1.18 | 0.91–1.53 | 1.1 | 0.85–1.44 | ||||||||||
Instrumental vaginald | 12 | 2.4 | 189 | 1.8 | 1.41 | 0.80–2.50 | 1.55 | 0.87–2.76 | 1.55 | 0.87–2.77 | 1.57 | 0.87–2.83 | ||||||||||
Emergency caesarean | 38 | 7.6 | 788 | 7.6 | 1.00 | 0.71–1.40 | 0.98 | 0.70–1.38 | 0.94 | 0.67–1.32 | 0.96 | 0.68–1.37 | ||||||||||
Perineal injury 3rd and 4th degree | 5 | 1.0 | 49 | 0.5 | 2.12 | 0.84–5.35 | 2.08 | 0.81–5.34 | 2.19 | 0.85–5.64 | 1.96 | 0.73–5.22 | ||||||||||
Apgar score < 7 at 5 minutes | 8 | 1.8 | 131 | 1.3 | 1.28 | 0.62–2.62 | 1.39 | 0.67–2.88 | 1.22 | 0.59–2.54 | 1.15 | 0.54–2.45 | ||||||||||
Hospital stay (mother) after birth > 2 days | 105 | 21.1 | 2096 | 20.3 | 1.06 | 0.93–1.22 | 1.03 | 0.89–1.18 | 1.01 | 0.88–1.17 | 1.19 | 1.03–1.37 |
Migrant women with CBD | Swedish born women | ||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
(n = 379) | (n= 61,459) | ||||||||||||||||||||||
n | % | n | % | OR | CI 95% | adjORa | CI 95% | adjORb | CI 95% | adjORc | CI 95% | ||||||||||||
Births to nulliparous women | |||||||||||||||||||||||
Outcome | |||||||||||||||||||||||
Induction of labour | 72 | 19.0 | 8368 | 13.6 | 1.49 | 1.15–1.93 | 1.43 | 1.10–1.86 | 1.43 | 1.10–1.86 | 1.18 | 0.87–1.58 | |||||||||||
Epidural analgesia | 107 | 28.2 | 26,499 | 43.1 | 0.52 | 0.42–0.65 | 0.47 | 0.38–0.59 | 0.47 | 0.37–0.59 | 0.50 | 0.39–0.64 | |||||||||||
Nitrous oxide | 281 | 74.1 | 50,972 | 82.9 | 0.59 | 0.47–0.74 | 0.61 | 0.48–0.77 | 0.61 | 0.48–0.77 | 0.71 | 0.54–0.92 | |||||||||||
Bath | 25 | 6.6 | 8907 | 14.5 | 0.42 | 0.28–0.63 | 0.44 | 0.29–0.66 | 0.44 | 0.29–0.66 | 0.55 | 0.36–0.85 | |||||||||||
Non-instrumental birth | 267 | 70.4 | 44,108 | 71.8 | 0.94 | 0.75–1.17 | 0.82 | 0.65–1.02 | 0.82 | 0.65–1.03 | 0.89 | 0.69–1.14 | |||||||||||
Instrumental vaginal¹ | 34 | 9.0 | 6521 | 10.6 | 0.90 | 0.65–1.26 | 1.05 | 0.75–1.47 | 1.05 | 0.75–1.47 | 0.99 | 0.68–1.43 | |||||||||||
Emergency caesarean | 67 | 17.7 | 7841 | 12.8 | 1.47 | 1.13–1.91 | 1.62 | 1.24–2.12 | 1.61 | 1.22–2.11 | 1.43 | 1.05–1.94 | |||||||||||
Perineal injury 3rd and 4th degree | 6 | 1.6 | 1546 | 2.5 | 0.62 | 0.28–1.40 | 0.84 | 0.37–1.88 | 0.84 | 0.37–1.88 | 0.91 | 0.39–2.16 | |||||||||||
Apgarscore < 7 at 5 minutes | 9 | 2.4 | 1047 | 1.7 | 1.40 | 0.72–2.72 | 1.40 | 0.71–2.73 | 1.41 | 0.72–2.75 | 1.28 | 0.60–2.72 | |||||||||||
Hospital stay (mother) after birth > 2 days | 206 | 54.9 | 30,541 | 49.8 | 1.23 | 1.00-1.51 | 1.36 | 1.10–1.67 | 1.35 | 1.10–1.67 | 1.31 | 1.04–1.64 | |||||||||||
(n = 500) | (n = 68,247) | Births to parous women | |||||||||||||||||||||
Induction of labour | 89 | 17.8 | 7769 | 11.4 | 1.69 | 1.34–2.12 | 1.45 | 1.15–1.83 | 1.28 | 1.01–1.62 | 1.04 | 0.78–1.38 | |||||||||||
Epidural analgesia | 39 | 7.8 | 9940 | 14.6 | 0.50 | 0.36–0.69 | 0.46 | 0.33–0.64 | 0.42 | 0.30–0.59 | 0.40 | 0.28–0.58 | |||||||||||
Nitrous oxide | 321 | 64.2 | 50,413 | 73.9 | 0.63 | 0.53–0.76 | 0.65 | 0.54–0.78 | 0.66 | 0.55–0.79 | 0.68 | 0.54–0.84 | |||||||||||
Bath | 16 | 3.2 | 3790 | 5.6 | 0.56 | 0.34–0.93 | 0.65 | 0.39–1.07 | 0.66 | 0.40–1.09 | 0.88 | 0.50–1.53 | |||||||||||
Non-instrumental birthsd | 428 | 85.6 | 57,502 | 84.3 | 1.11 | 0.87–1.43 | 1.08 | 0.84–1.40 | 1.22 | 0.95–1.58 | 1.17 | 0.86–1.58 | |||||||||||
Instrumental vaginal¹ | 11 | 2.4 | 1435 | 2.1 | 1.21 | 0.70–2.10 | 1.30 | 0.74–2.27 | 1.28 | 0.73–2.24 | 1.38 | 0.70–2.72 | |||||||||||
Emergency caesarean | 38 | 7.6 | 4147 | 6.1 | 1.27 | 0.91–1.77 | 1.27 | 0.91–1.78 | 1.07 | 0.76–1.50 | 0.97 | 0.64–1.46 | |||||||||||
Perineal injury 3rd and 4th degree | 5 | 1.0 | 578 | 0.8 | 1.18 | 0.49–2.87 | 1.48 | 0.61–3.61 | 1.53 | 0.63–3.75 | 2.77 | 0.95–8.04 | |||||||||||
Apgar score < 7 at 5 minutes | 8 | 1.8 | 694 | 1.1 | 1.60 | 0.79–3.22 | 1.53 | 0.75–3.11 | 1.27 | 0.62–2.60 | 1.05 | 0.45–2.47 | |||||||||||
Hospital stay after birth (mother) > 2 days | 105 | 21.1 | 14,056 | 20.6 | 1.03 | 0.83–1.28 | 1.08 | 0.87–1.35 | 1.00 | 0.80–1.25 | 0.95 | 0-73-1.23 |