What question did this study set out to answer?

This study aims to describe the socio-demographic characteristics and obstetric outcomes of second-generation mothers compared to first-generation and native mothers.

April 1, 2026Open Access

Obstetric outcomes in second-generation and migrant mothers: a cohort study in the Emilia-Romagna Region, Italy

Key Points

This study aims to describe the socio-demographic characteristics and obstetric outcomes of second-generation mothers compared to first-generation and native mothers.
Linked deliveries from the Emilia-Romagna Birth Registry with the 2011 Population Census to define migratory background.
Examined outcomes including cesarean delivery rates, preterm birth, small for gestational age, and late antenatal care.
Employed log-binomial models to estimate prevalence ratios stratified by area of origin.
Of 390,062 births, migratory background could be defined for 63%.
Second-generation mothers were generally younger and less educated than native mothers, with 79.5% holding Italian citizenship.
Lower risk of elective cesarean delivery (adjusted prevalence ratio 0.65) but higher risks of emergency cesarean delivery (1.15), late antenatal care (1.91), preterm birth (1.59), and small for gestational age (1.15).
Sub-Saharan African origin had increased risks for negative obstetric outcomes.

Abstract

Abstract Purpose The second generation (people born in the host country to foreign parents) has grown significantly in Italy. While migration is known to impact maternal and neonatal health negatively, evidence on outcomes for second-generation mothers (SGMs) is limited. This study aimed to describe the socio-demographic characteristics and obstetric outcomes of SGMs, comparing them with first-generation and native mothers in an Italian region. Methods All deliveries in the Emilia-Romagna Birth Registry (2012–2023) were linked with the 15th Population Census (2011); this allowed the definition of migratory background. The outcomes included emergency and elective cesarean delivery, preterm birth, small for gestational age (SGA), and late antenatal care (ANC). Log-binomial models were used to estimate crude and adjusted prevalence ratios (aPR), also stratified by area of origin. Results 390,062 births were recorded; for 63%, it was possible to define the migratory background. Compared to native mothers, SGMs were younger and less educated; 79.5% held Italian citizenship. SGMs showed a lower risk of elective cesarean delivery (aPR 0.65, 95% CI 0.53–0.79) and higher risks of late ANC (aPR 1.91, 95% CI 1.69–2.15), emergency cesarean delivery (aPR 1.15, 95%CI 1.00–1.31), preterm birth (aPR 1.59, 95% CI 1.33–1.90), and SGA (aPR 1.15, 95% CI 0.99–1.33). Certain areas of origin, such as Sub-Saharan Africa, seemed to have an increased risk of negative outcomes. Conclusions SGMs show worse social determinants and birth outcomes than natives. Currently, the second generation cannot be identified through administrative data; however, it merits greater attention, in terms of monitoring tools and health and social policies.

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