Comparing Pregnancy outcomes of Immigrants from Ethiopia and the Former Soviet Union to Israel to those of native-born Israelis.

INTRODUCTION: Pregnancy outcomes of two immigrant groups to Israel, from Europe and Africa, were compared those of native-born Israelis, in a context of universal health insurance and equal access to perinatal services.
METHODS: The data source was the computerized perinatal database of Soroka University Medical Center, the regional hospital, where most births in southern Israel occur. All singleton deliveries in the years 1988–2011 of immigrants from Ethiopia ( n = 1,667) and Former-USSR ( n = 12,920) who began their childbearing in Israel were compared with those of Israeli-born women ( n = 63,405). Primary outcomes were: preterm delivery (<37 weeks gestation) (PTD) and perinatal mortality (PM). Generalized equation estimation (GEE) multivariable models were used to adjust for potential confounders.

RESULTS: PTD rates of immigrants from Ethiopia and former-USSR were similar to those of Israeli-born (8.7%, 7.5% and 7.5% respectively), but both immigrant groups had significantly ( P <0.001) higher rates of PM than Israeli-born (21/1000 in the Ethiopian group, and 11/1000 in the Former-USSR group, compared to 9/1000). When adjusted for lack of antenatal care, out-of-hospital births, preterm, and extremes of maternal age, both immigrant groups, compared to Israeli-born, had significantly increased risk for perinatal mortality; however, the relative risk associated with Ethiopian origin was about twice that associated with former-USSR origin (OR = 2.349, 95% CI 1.609; 3.429, and OR = 1.303, 95% CI 1.067; 1.592, respectively).
CONCLUSIONS: Universal health care insurance and equal access to perinatal services do not eliminate gaps in perinatal mortality between immigrants and native-born nor do they eliminate differences between immigrants from Africa and Europe.