Access to Perinatal Healthcare in Minority Anglophones: Hospital Type and Birth Outcomes

The authors assessed the relationship between hospital characteristics and risk of adverse birth outcomes among Montreal’s minority Anglophones. Their study included 124,670 births among Anglophones between 1998 and 2019. They estimated risk ratios (RR) and 95 percent confidence intervals (CI) for the association between hospital characteristics, including residential proximity to hospitals and language in which medical services are provided, and risks of preterm birth and stillbirth. Models were adjusted for maternal socioeconomic status and other characteristics. In their study, 8 percent of Anglophones had a preterm birth and 0.4 percent a stillbirth. Anglophone women who delivered at a farther French hospital had a greater risk of stillbirth (RR 1.67, 95% CI 1.28-2.18) than preterm birth (RR 1.21, 95 percent CI 1.14-1.30), compared with delivery at hospitals closer to home. In contrast, the authors found that delivery at a farther English hospital was associated with similar risks of stillbirth (RR 1.36, 95 percent CI 1.08-1.71) and preterm birth (RR 1.36, 95 percent CI 1.29-1.44). The greater risk of stillbirth with delivery at a farther French hospital, versus greater risk of preterm birth at a farther English hospital, remained present in their analyses stratified by maternal age, education, material deprivation, and region of origin. The authors conclude that minority Anglophones in Montreal who travel to a farther French hospital for delivery have a greater risk of stillbirth than Anglophones who travel to a farther English hospital. This novel observation suggests to the authors that there is a need to determine if access to perinatal healthcare in a woman's language may help reduce the risk of stillbirth.

PLoS ONE

Vol. 18

no. 4

April 18, 2023

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