Karolina S. Mæland

Karolina Mæland’s thesis is an epidemiological study, investigating associations between maternal migration-related factors, i.e., country of birth, reason for immigration, length of residence, and adverse perinatal outcomes, i.e., placental abruption, risk of subsequent preeclampsia, and perinatal mortality, in immigrant and non-immigrant women giving birth in Norway during 1990 and 2016. 

The study was a nationwide population-based study using data from the Medical Birth Registry of Norway and Statistics Norway between 1990/1999 and 2016. Mæland estimated the following: i) The prevalence and odds of placental abruption in immigrant women compared to non-immigrants by maternal country of birth, reason for immigration, and length of residence using logistic regression with robust standard error estimations; ii) Associations between preeclampsia in the second pregnancy for women with preeclampsia in the first pregnancy, in immigrants and non-immigrants overall, and by migration-related factors, using a log-binominal regression model; and iii) The odds of adverse perinatal outcomes for women with non-registered ultrasound examination in pregnancy, compared to women with registered ultrasound examination, in immigrant and non-immigrant women. Associations were investigated using logistic regression with robust standard errors. Effect estimates were reported as crude and adjusted odds- or risk ratios with 95% confidence intervals. 

Mæland found that the risk of adverse perinatal outcomes, and the registration of prenatal ultrasound examination during pregnancy, varied by maternal country of birth. Specifically, the risk of placental abruption and non-registered ultrasound examination in pregnancy was highest for immigrant women born in the sub-Saharan African region. For women with preeclampsia in the first pregnancy, immigrant women born in Latin America and the Caribbean had the highest risk of preeclampsia in the second pregnancy. Both immigrant and non-immigrant women with non-registered ultrasound examinations in pregnancy had an increased risk of perinatal mortality than women with ultrasound registered in pregnancy.  

Mæland’s thesis identified subgroups of immigrant women at increased risk of placental abruption, subsequent preeclampsia, non-registered ultrasound examination in pregnancy and perinatal mortality. The results highlight a need in maternity care services for tailored and intelligible information on procedures and preventive efforts to reduce adverse perinatal outcomes for immigrant women at increased risk, and the importance of ensuring complete and accurate obstetric history taking for immigrant women. 

Karolina S. Mæland (47) is a nurse and holds a master’s degree in midwifery from University of South-Eastern Norway (USN). She defended her thesis October 19^th, 2023. Her PhD was an epidemiological study, undertaken at the PhD program in Health, Function and Participation at the faculty of Health and Social sciences at Western Norway University of Applied Sciences, Bergen. 

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