Background
Methods
Statistical analysis
Results
Mother's region or country of birth* | Years 1996-1998 | Mother's region or country of birth* | Years 2006-2008 | |||
---|---|---|---|---|---|---|
n | % | n | % | |||
Western developed countries | 3884 | 26.1 | Western developed countries | 3683 | 10.9 | |
France
|
615
|
4.1
| Germany
|
679
|
2.0
| |
Switzerland
|
553
|
3.7
| Switzerland
|
545
|
1.6
| |
United Kingdom
|
470
|
3.2
| France
|
497
|
1.5
| |
Eastern Europe | 3781 | 25.4 | Eastern Europe | 18650 | 55.1 | |
Poland
|
1273
|
8.5
| Romania
|
11841
|
35.0
| |
Montenegro
|
753
|
5.1
| Poland
|
1859
|
5.5
| |
Romania
|
641
|
4.3
| Albania
|
1442
|
4.3
| |
North Africa | 1310 | 8.8 | North Africa | 1889 | 5.6 | |
Egypt
|
373
|
2.5
| Morocco
|
753
|
2.2
| |
Morocco
|
358
|
2.4
| Egypt
|
555
|
1.6
| |
Tunisia
|
309
|
2.1
| Tunisia
|
338
|
1.0
| |
West and sub-Saharan Africa | 1064 | 7.1 | West and sub-Saharan Africa | 1469 | 4.3 | |
Ethiopia
|
229
|
1.5
| Nigeria
|
403
|
1.2
| |
Nigeria
|
209
|
1.4
| Ethiopia
|
278
|
0.8
| |
Cape Verde
|
135
|
0.9
| Cape Verde
|
90
|
0.3
| |
Central and South America | 2030 | 13.6 | Central and South America | 3588 | 10.6 | |
Peru
|
558
|
3.7
| Peru
|
905
|
2.7
| |
Brazil
|
370
|
2.5
| Ecuador
|
573
|
1.7
| |
Venezuela
|
244
|
1.6
| Brazil
|
553
|
1.6
| |
Western and Central-Southern Asia | 916 | 6.1 | Western and Central-Southern Asia | 2061 | 6.1 | |
India
|
360
|
2.4
| Bangladesh
|
737
|
2.2
| |
Sri Lanka (Ceylon)
|
190
|
1.3
| India
|
598
|
1.8
| |
Bangladesh
|
144
|
1.0
| Sri Lanka (Ceylon)
|
371
|
1.1
| |
East Asia | 1916 |
12.9
| East Asia |
2490
|
7.4
| |
Philippines
|
1404
|
9.4
| Philippines
|
1324
|
3.9
| |
China
|
349
|
2.3
| China
|
1027
|
3.0
| |
South Korea
|
64
|
0.4
| Thailand
|
45
|
0.1
| |
Total | 14901 | 100.0 | Total | 33830 | 100.0 |
Italy | Western developed countries | Eastern Europe | North Africa | |||||
---|---|---|---|---|---|---|---|---|
'96-'98 | '06-'08 | '96-'98 | '06-'08 | '96-'98 | '06-'08 | '96-'98 | '06-'08 | |
N = 120886 | N = 127122 | N = 3884 | N = 3683 | N = 3781 | N = 18650 | N = 1310 | N = 1889 | |
MATERNAL CHARACTERISTICS | ||||||||
Mother's age* | ||||||||
15-19 | 1.0 | 1.0 | 0.5 | 0.3 | 6.6 | 5.9 | 2.3 | 1.7 |
20-24 | 9.1 | 5.5 | 8.2 | 3.0 | 30.0 | 23.7 | 16.0 | 16.5 |
25-34 | 70.4 | 57.9 | 71.5 | 52.9 | 55.3 | 58.0 | 58.9 | 56.7 |
35-44 | 19.3 | 35.3 | 19.5 | 43.5 | 7.7 | 12.2 | 22.4 | 24.7 |
45-59 | 0.2 | 0.3 | 0.2 | 0.3 | 0.2 | 0.1 | 0.2 | 0.3 |
Missing | 0.1 | 0.0 | 0.1 | 0.0 | 0.2 | 0.1 | 0.2 | 0.0 |
Educational level attained* | ||||||||
None or elementary school | - | 10.6 | - | 14.2 | - | 15.2 | - | 21.2 |
Middle school | - | 25.2 | - | 18.4 | - | 41.4 | - | 41.5 |
High school | - | 47.1 | - | 41.6 | - | 37.2 | - | 28.0 |
Higher education | - | 17.0 | - | 25.7 | - | 6.0 | - | 9.3 |
Missing | - | 0.2 | - | 0.2 | - | 0.2 | - | 0.1 |
Marital status* | ||||||||
Unmarried | - | 25.1 | - | 24.4 | - | 29.7 | - | 9.2 |
Married | - | 71.8 | - | 72.2 | - | 66.9 | - | 88.6 |
Separated | - | 1.6 | - | 1.3 | - | 0.9 | - | 0.7 |
Divorced | - | 0.8 | - | 1.2 | - | 1.3 | - | 0.3 |
Widowed | - | 0.1 | - | 0.1 | - | 0.1 | - | 0.0 |
Missing | - | 0.6 | - | 0.7 | - | 1.1 | - | 1.2 |
First prenatal visit (weeks)* | ||||||||
<12 | 94.8 | 98.8 | 94.5 | 98.6 | 84.1 | 92.8 | 90.2 | 93.8 |
≥12 | 5.2 | 1.2 | 5.5 | 1.3 | 15.8 | 6.9 | 9.8 | 5.9 |
Missing | 0.0 | 0.0 | 0.0 | 0.1 | 0.1 | 0.3 | 0.0 | 0.3 |
Parity* | ||||||||
0 | 53.1 | 56.3 | 51.4 | 53.7 | 59.9 | 61.1 | 44.7 | 40.1 |
1 | 37.0 | 35.1 | 37.5 | 35.3 | 24.6 | 28.2 | 37.1 | 33.9 |
≥2 | 10.0 | 8.6 | 11.0 | 11.0 | 15.5 | 10.7 | 18.2 | 26.0 |
PERINATAL OUTCOMES | ||||||||
Gestational age (weeks) | ||||||||
<31 | 0.7 | 0.6 | 0.8 | 0.5 | 1.1 | 1.3 | 0.5 | 0.6 |
32-36 | 4.8 | 5.2 | 4.9 | 5.1 | 6.1 | 6.7 | 6.9 | 5.1 |
37+ | 93.8 | 94.1 | 93.3 | 94.4 | 88.0 | 92.0 | 91.5 | 94.3 |
Missing | 0.7 | 0.0 | 1.0 | 0.0 | 4.8 | 0.0 | 1.1 | 0.0 |
Five Minute Apgar Score | ||||||||
0-6 | 1.7 | 1.4 | 2.0 | 1.1 | 1.9 | 1.4 | 2.1 | 1.8 |
7-10 | 97.8 | 98.6 | 97.0 | 98.9 | 97.5 | 98.6 | 97.8 | 98.2 |
Missing | 0.4 | 0.0 | 1.0 | 0.0 | 0.5 | 0.0 | 0.2 | 0.0 |
Respiratory diseases | 6.9 | 4.6 | 7.3 | 3.7 | 8.0 | 5.9 | 8.9 | 6.4 |
Special/intensive care | 3.8 | 3.6 | 3.4 | 3.0 | 5.1 | 5.2 | 4.8 | 4.6 |
Congenital Malformations | 3.8 | 5.4 | 3.2 | 4.9 | 4.2 | 5.6 | 3.2 | 6.0 |
West and sub-Saharan Africa | Central and South America | Western and Central-Southern Asia | East Asia | |||||
'96-'98 | '06-'08 | '96-'98 | '06-'08 | '96-'98 | '06-'08 | '96-'98 | '06-'08 | |
N = 1064 | N = 1469 | N = 2030 | N = 3588 | N = 916 | N = 2061 | N = 1916 | N = 2490 | |
MATERNAL CHARACTERISTICS | ||||||||
Mother's age* | ||||||||
15-19 | 0.9 | 1.6 | 2.0 | 2.7 | 1.1 | 1.3 | 0.8 | 2.2 |
20-24 | 12.6 | 9.3 | 13.8 | 12.4 | 23.0 | 19.7 | 11.8 | 16.1 |
25-34 | 64.6 | 60.9 | 60.0 | 57.1 | 61.0 | 64.5 | 66.3 | 56.3 |
35-44 | 21.4 | 27.9 | 23.9 | 27.5 | 14.4 | 14.1 | 20.8 | 24.8 |
45-59 | 0.4 | 0.3 | 0.1 | 0.3 | 0.4 | 0.3 | 0.2 | 0.6 |
Missing | 0.1 | 0.0 | 0.1 | 0.0 | 0.0 | 0.0 | 0.1 | 0.0 |
Educational level attained* | ||||||||
None or elementary school | - | 21.4 | - | 15.2 | - | 23.6 | - | 22.3 |
Middle school | - | 40.0 | - | 33.7 | - | 43.5 | - | 39.6 |
High school | - | 32.4 | - | 40.8 | - | 25.6 | - | 31.2 |
Higher education | - | 6.1 | - | 9.9 | - | 7.0 | - | 6.8 |
Missing | - | 0.1 | - | 0.3 | - | 0.3 | - | 0.1 |
Marital status* | ||||||||
Unmarried | - | 33.1 | - | 35.6 | - | 8.7 | - | 23.9 |
Married | - | 64.3 | - | 60.7 | - | 90.0 | - | 74.7 |
Separated | - | 1.4 | - | 1.8 | - | 0.3 | - | 0.6 |
Divorced | - | 0.4 | - | 1.0 | - | 0.1 | - | 0.1 |
Widowed | - | 0.1 | - | 0.1 | - | 0.1 | - | 0.4 |
Missing | - | 0.7 | - | 0.7 | - | 0.7 | - | 0.4 |
First prenatal visit (weeks)* | ||||||||
<12 | 87.9 | 92.8 | 92.0 | 96.7 | 87.8 | 92.4 | 82.3 | 92.1 |
≥12 | 12.0 | 7.0 | 8.0 | 3.2 | 12.2 | 7.5 | 17.7 | 7.8 |
Missing | 0.1 | 0.2 | 0.0 | 0.1 | 0.0 | 0.1 | 0.0 | 0.1 |
Parity* | ||||||||
0 | 50.3 | 48.8 | 55.1 | 53.0 | 57.5 | 50.9 | 51.8 | 49.2 |
1 | 30.8 | 33.2 | 33.1 | 33.7 | 33.0 | 35.9 | 34.8 | 36.1 |
≥2 | 18.9 | 18.0 | 11.8 | 13.3 | 9.5 | 13.2 | 13.4 | 14.8 |
PERINATAL OUTCOMES | ||||||||
Gestational age (weeks) | ||||||||
<31 | 3.0 | 2.3 | 1.2 | 0.8 | 1.1 | 0.9 | 1.0 | 1.0 |
32-36 | 6.7 | 7.5 | 5.2 | 7.3 | 5.7 | 7.5 | 6.3 | 6.2 |
37+ | 88.6 | 90.2 | 92.5 | 91.9 | 91.8 | 91.6 | 90.7 | 92.8 |
Missing | 1.7 | 0.0 | 1.2 | 0.0 | 1.4 | 0.0 | 1.9 | 0.0 |
Five Minute Apgar Score | ||||||||
0-6 | 3.9 | 1.6 | 1.8 | 2.2 | 1.5 | 2.2 | 1.5 | 1.8 |
7-10 | 95.8 | 98.4 | 97.8 | 97.8 | 98.5 | 97.8 | 98.3 | 98.2 |
Missing | 0.4 | 0.0 | 0.3 | 0.0 | 0.0 | 0.0 | 0.2 | 0.0 |
Respiratory diseases | 11.4 | 7.3 | 7.9 | 4.9 | 7.2 | 5.5 | 8.0 | 4.5 |
Special/intensive care | 8.0 | 7.7 | 4.5 | 4.9 | 5.0 | 5.9 | 6.4 | 3.8 |
Congenital Malformations | 4.2 | 8.6 | 4.5 | 5.4 | 3.6 | 6.7 | 3.2 | 5.2 |
Outcomes
Outcome | Model 1a: '96-'98 | Model 1b: '06-'08 | Model 2: '06-'08 vs. '96-'98 | |||
---|---|---|---|---|---|---|
ORs | 95%CIs | ORs | 95%CIs | ORs | 95%CIs | |
Gestational Age | ||||||
<31 vs.≥37 | ||||||
Italy | 1.00 | 1.00 | 0.88 | (0.80-0.97) | ||
Eastern Europe | 1.65 | (1.21-2.25) | 2.11 | (1.80-2.47) | 1.12 | (0.89-1.42) |
North Africa | 0.78 | (0.56-1.10) | 0.94 | (0.46-1.93) | 1.05 | (0.40-2.76) |
West and sub-Saharan Africa | 4.55 | (2.88-7.18) | 3.91 | (2.85-5.35) | 0.76 | (0.55-1.04) |
Central and South America | 1.71 | (1.15-2.54) | 1.29 | (0.95-1.75) | 0.66 | (0.44-1.01) |
Western and Central-Southern Asia | 1.59 | (0.80-3.17) | 1.45 | (0.86-2.45) | 0.80 | (0.46-1.39) |
East Asia | 1.54 | (1.04-2.27) | 1.71 | (0.88-3.33) | 0.98 | (0.69-1.38) |
ALL REGIONS | 1.80 | (1.44-2.28) | 1.95 | (1.72-2.21) | 0.95 | (0.77-1.16) |
32-36 vs.≥37 | ||||||
Italy | 1.00 | 1.00 | 1.09 | (1.05-1.13) | ||
Eastern Europe | 1.35 | (1.06-1.72) | 1.31 | (1.19-1.46) | 1.06 | (0.87-1.30) |
North Africa | 1.48 | (1.22-1.78) | 0.98 | (0.71-1.34) | 0.72 | (0.55-0.95) |
West and sub-Saharan Africa | 1.48 | (1.11-1.97) | 1.49 | (1.27-1.75) | 1.10 | (0.89-1.37) |
Central and South America | 1.10 | (0.92-1.31) | 1.42 | (1.26-1.62) | 1.42 | (1.12-1.79) |
Western and Central-Southern Asia | 1.21 | (0.99-1.48) | 1.47 | (1.28-1.70) | 1.32 | (0.96-1.84) |
East Asia | 1.37 | (0.92-2.04) | 1.19 | (0.92-1.57) | 0.96 | (0.80-1.14) |
ALL REGIONS | 1.32 | (1.16-1.50) | 1.32 | (1.25-1.39) | 1.09 | (0.96-1.23) |
Five Minute Apgar Score (0-6 vs. 7-10) | ||||||
Italy | 1.00 | 1.00 | 0.81 | (0.76-0.87) | ||
Eastern Europe | 1.13 | (0.86-1.49) | 1.02 | (0.91-1.15) | 0.73 | (0.53-1.00) |
North Africa | 1.21 | (0.80-1.82) | 1.29 | (0.93-1.79) | 0.87 | (0.72-1.04) |
West and sub-Saharan Africa | 2.30 | (1.55-3.41) | 1.17 | (0.69-1.97) | 0.41 | (0.22-0.77) |
Central and South America | 1.07 | (0.72-1.58) | 1.57 | (1.25-1.96) | 1.19 | (0.85-1.67) |
Western and Central-Southern Asia | 0.89 | (0.49-1.61) | 1.57 | (0.90-2.74) | 1.44 | (0.55-3.72) |
East Asia | 0.88 | (0.81-0.96) | 1.32 | (1.26-1.40) | 1.22 | (1.13-1.31) |
ALL REGIONS | 1.18 | (0.99-1.40) | 1.17 | (1.03-1.34) | 0.81 | (0.66-1.00) |
Respiratory diseases (yes vs. no) | ||||||
Italy | 1.00 | 1.00 | 0.66 | (0.63-0.68) | ||
Eastern Europe | 1.17 | (1.10-1.24) | 1.28 | (1.22-1.34) | 0.72 | (0.67-0.77) |
North Africa | 1.31 | (0.98-1.75) | 1.40 | (1.23-1.60) | 0.70 | (0.58-0.86) |
West and sub-Saharan Africa | 1.73 | (1.46-2.05) | 1.61 | (1.34-1.93) | 0.61 | (0.50-0.75) |
Central and South America | 1.15 | (0.98-1.35) | 1.05 | (0.94-1.18) | 0.60 | (0.51-0.71) |
Western and Central-Southern Asia | 1.05 | (0.85-1.29) | 1.20 | (0.99-1.47) | 0.75 | (0.66-0.87) |
East Asia | 1.18 | (1.03-1.35) | 0.97 | (0.72-1.29) | 0.54 | (0.44-0.65) |
ALL REGIONS | 1.22 | (1.15-1.31) | 1.24 | (1.17-1.32) | 0.66 | (0.62-0.71) |
Special/intensive care (yes vs. no) | ||||||
Italy | 1.00 | 1.00 | 0.96 | (0.92-1.00) | ||
Eastern Europe | 1.36 | (1.22-1.52) | 1.46 | (1.33-1.59) | 1.02 | (0.93-1.13) |
North Africa | 1.29 | (0.95-1.74) | 1.28 | (0.99-1.66) | 0.95 | (0.83-1.10) |
West and sub-Saharan Africa | 2.21 | (1.73-2.82) | 2.22 | (1.89-2.60) | 0.96 | (0.76-1.21) |
Central and South America | 1.21 | (0.97-1.50) | 1.36 | (1.16-1.60) | 1.08 | (0.91-1.28) |
Western and Central-Southern Asia | 1.35 | (1.06-1.71) | 1.66 | (1.48-1.86) | 1.18 | (0.86-1.62) |
East Asia | 1.75 | (1.41-2.16) | 1.04 | (0.65-1.66) | 0.57 | (0.43-0.77) |
ALL REGIONS | 1.47 | (1.30-1.66) | 1.45 | (1.34-1.57) | 0.95 | (0.92-1.00) |
Congenital malformations (yes vs. no) | ||||||
Italy | 1.00 | 1.00 | 1.45 | (1.40-1.51) | ||
Eastern Europe | 1.12 | (0.96-1.30) | 1.04 | (0.98-1.10) | 1.35 | (1.13-1.60) |
North Africa | 0.84 | (0.60-1.16) | 1.12 | (0.91-1.37) | 1.94 | (1.09-3.44) |
West and sub-Saharan Africa | 1.12 | (0.89-1.39) | 1.65 | (1.45-1.86) | 2.14 | (1.69-2.72) |
Central and South America | 1.20 | (0.94-1.53) | 1.00 | (0.90-1.11) | 1.21 | (0.93-1.57) |
Western and Central-Southern Asia | 0.94 | (0.81-1.11) | 1.25 | (1.01-1.54) | 1.92 | (1.46-2.52) |
East Asia | 0.84 | (0.66-1.08) | 0.95 | (0.83-1.09) | 1.63 | (1.40-1.91) |
ALL REGIONS | 1.03 | (0.93-1.15) | 1.07 | (1.00-1.15) | 1.50 | (1.32-1.71) |