Table 5:

Risk of severe neonatal morbidity and neonatal mortality (SNMM) arising in the index birth admission and up to 27 days thereafter, among newborns of immigrant mothers from the 20 countries contributing the greatest number of births in Ontario, relative to newborns of nonimmigrant females*

Maternal country of birth exposure groupNo. with SNMM (rate per 1000 live births)Unadjusted RR (95% CI)Adjusted RR (95% CI)§
Nonimmigrant (n = 266 191)17 457 (65.6)1.00 (Ref.)1.00 (Ref.)
China (n = 13 077)389 (29.7)0.45 (0.41 to 0.50)0.44 (0.40 to 0.48)
Lebanon (n = 1863)62 (33.3)0.51 (0.40 to 0.65)0.52 (0.41 to 0.67)
Vietnam (n = 3738)130 (34.8)0.53 (0.45 to 0.63)0.54 (0.46 to 0.64)
Poland (n = 1616)58 (35.9)0.55 (0.43 to 0.71)0.55 (0.42 to 0.70)
Sri Lanka (n = 7797)329 (42.2)0.64 (0.58 to 0.72)0.66 (0.60 to 0.74)
Pakistan (n = 15 158)641 (42.3)0.64 (0.60 to 0.70)0.68 (0.63 to 0.73)
India (n = 21 123)966 (45.7)0.70 (0.66 to 0.74)0.73 (0.68 to 0.77)
Iraq (n = 2175)102 (46.9)0.71 (0.58 to 0.87)0.74 (0.61 to 0.90)
Afghanistan (n = 2619)132 (50.4)0.77 (0.65 to 0.91)0.82 (0.69 to 0.98)
Nigeria (n = 1579)83 (52.6)0.80 (0.65 to 0.99)0.78 (0.63 to 0.97)
Romania (n = 1281)68 (53.1)0.81 (0.64 to 1.02)0.76 (0.60 to 0.95)
Bangladesh (n = 5156)275 (53.3)0.81 (0.72 to 0.91)0.84 (0.75 to 0.94)
Philippines (n = 15 084)968 (64.2)0.98 (0.92 to 1.04)0.93 (0.87 to 0.99)
Somalia (n = 2131)113 (53.0)0.82 (0.68 to 0.98)0.84 (0.70 to 1.01)
Iran (n = 1644)99 (60.2)0.92 (0.76 to 1.11)0.84 (0.69 to 1.01)
Ethiopia (n = 2075)125 (60.2)0.92 (0.77 to 1.10)0.92 (0.77 to 1.10)
Guyana (n = 3538)215 (60.8)0.93 (0.81 to 1.06)0.95 (0.83 to 1.08)
Trinidad and Tobago (n = 1555)100 (64.3)0.98 (0.81 to 1.19)0.98 (0.81 to 1.20)
Jamaica (n = 7971)580 (72.8)1.11 (1.03 to 1.21)1.14 (1.05 to 1.23)
Ghana (n = 2731)207 (75.8)1.16 (1.01 to 1.34)1.20 (1.05 to 1.38)
  • Note: CI = confidence interval, Ref. = reference category, RR = relative risk.

  • * Data are limited to births to females who resided in an urban neighbourhood of the lowest income quintile and who had a singleton, in-hospital live birth at 20–42 weeks’ gestation in Ontario, Canada, from 2002 to 2019, excluding refugee immigrants.

  • Excludes 38 births to females missing world region of birth, and 34 101 births to females not originating from 1 of the top 20 countries.

  • Using modified Poisson regression with a robust error variance. Generalized estimating equations with an exchangeable correlation structure accounted for correlated errors of potentially more than 1 birth clustered within the same mother.

  • § Adjusted for maternal age (15–19 yr, 20–29 yr, 30–39 yr, 40–50 yr), parity (0, 1, 2, ≥ 3) and any structural congenital anomaly (yes or no).