International Journal of Public Health

, Volume 63, Issue 9, pp 1027–1036 | Cite as

The perinatal health of immigrant women in France: a nationally representative study

  • Fabienne El-Khoury LesueurEmail author
  • Anne-Laure Sutter-Dallay
  • Lidia Panico
  • Elie Azria
  • Judith Van der Waerden
  • Nolwenn Regnault Vauvillier
  • Marie-Aline Charles
  • Maria Melchior
Original Article



Despite the healthy migrant effect, immigrants and descendants of immigrants face health challenges and socio-economic difficulties. The objective of this study is to examine the perinatal health of women of migrant origin.


The nationwide French ELFE (Etude Longitudinale Française Depuis l’Enfance) birth cohort study recruited approximately 18,000 women. We studied pre-pregnancy BMI, gestational diabetes mellitus (GDM), as well as tobacco, and alcohol consumption during pregnancy according to migrant status and region of origin.


Women from North Africa and Turkey had a higher risk of pre-pregnancy overweight and GDM, while women from Eastern Europe and Asia had a lower risk of pre-pregnancy overweight and obesity, but a higher risk of GDM compared to non-immigrants. Women from Sub-Saharan Africa had a higher risk of being overweight or obese pre-pregnancy. Compared to non-immigrants, immigrants—but not descendants of immigrants—had lower levels of tobacco smoking, while descendants of immigrants were less likely to drink alcohol during pregnancy.


Pregnant women of migrant origin have particular health needs and should benefit from a medical follow-up which addresses those needs.


Migrant Women Maternal health Pregnancy Overweight Obesity Gestational diabetes mellitus Smoking Alcohol 


Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The ELFE study received approval from France’s consultative committee for the treatment for health information for research (CCTIRS) and the national data protection authority (CNIL).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

38_2018_1146_MOESM1_ESM.pdf (781 kb)
Supplementary material 1 (PDF 781 kb)


  1. Agrawal A, Scherrer JF, Grant JD et al (2010) The effects of maternal smoking during pregnancy on offspring outcomes. Prev Med 50:13–18. CrossRefPubMedGoogle Scholar
  2. Almeida LM, Caldas J, Ayres-de-Campos D et al (2013) Maternal healthcare in migrants: a systematic review. Matern Child Health J 17:1346–1354. CrossRefPubMedGoogle Scholar
  3. Barker DJ (2012) Sir Richard Doll Lecture. Developmental origins of chronic disease. Public Health 126:185–189. CrossRefPubMedGoogle Scholar
  4. Beauchemin C, Hamel C, Simon P, Héran F (eds) (2015) Trajectoires et origines: enquête sur la diversité des populations en France. Ined ditions, ParisGoogle Scholar
  5. Bethel JW, Schenker MB (2005) Acculturation and smoking patterns among hispanics: a review. Am J Prev Med 29:143–148. CrossRefPubMedGoogle Scholar
  6. Cosson E, Cussac-Pillegand C, Benbara A et al (2014) The diagnostic and prognostic performance of a selective screening strategy for gestational diabetes mellitus according to ethnicity in Europe. J Clin Endocrinol Metab 99:996–1005. CrossRefPubMedGoogle Scholar
  7. Crowther CA, Hiller JE, Moss JR et al (2005) Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med 352:2477–2486. CrossRefPubMedGoogle Scholar
  8. Davies A, Basten A, Frattini C (2009) Migration: a social determinant of the health of migrants. International Organization for Migration, GenevaGoogle Scholar
  9. Delavari M, Sønderlund AL, Swinburn B et al (2013) Acculturation and obesity among migrant populations in high income countries—a systematic review. BMC Public Health 13:458. CrossRefPubMedPubMedCentralGoogle Scholar
  10. Dow C, Fosse-Edorh S, Perrine A et al (2016) CA-107: Dépistage, prévalence et pronostic du diabète gestationnel en France en 2011: l’étude ELFE. Diabetes Metab 42:A64. CrossRefGoogle Scholar
  11. Europ-Peristat (2013) The European Perinatal Health Report. The health and care of pregnant women and babies in Europe in 2010Google Scholar
  12. Falah-Hassani K, Shiri R, Vigod S, Dennis C-L (2015) Prevalence of postpartum depression among immigrant women: a systematic review and meta-analysis. J Psychiatr Res 70:67–82. CrossRefPubMedGoogle Scholar
  13. Gagnon AJ, Zimbeck M, Zeitlin J (2010) Migration and perinatal health surveillance: an international Delphi survey. Eur J Obstet Gynecol Reprod Biol 149:37–43. CrossRefPubMedGoogle Scholar
  14. Gagnon AJ, McDermott S, Rigol-Chachamovich J et al (2011) International migration and gestational diabetes mellitus: a systematic review of the literature and meta-analysis. Paediatr Perinat Epidemiol 25:575–592. CrossRefPubMedGoogle Scholar
  15. Gilbert PA, Khokhar S (2008) Changing dietary habits of ethnic groups in Europe and implications for health. Nutr Rev 66:203–215. CrossRefPubMedGoogle Scholar
  16. Guardia D, Salleron J, Roelandt J-L, Vaiva G (2016) Prévalence des troubles psychiatriques et addictologiques auprès de trois générations successives de migrants: résultats d’une étude menée en population générale. L’Encéphale. CrossRefPubMedGoogle Scholar
  17. Khlat M, Guillot M (2017) Health and mortality patterns among migrants in France. Population Center Working Papers PSCPARCGoogle Scholar
  18. Kulu H, González-Ferrer A (2014) Family dynamics among immigrants and their descendants in Europe: current research and opportunities. Eur J Popul 30:411–435. CrossRefGoogle Scholar
  19. Kulu H, Hannemann T, Pailhé A et al (2017) Fertility by birth order among the descendants of immigrants in selected European countries. Popul Dev Rev 43:31–60. CrossRefGoogle Scholar
  20. Mårdby A-C, Lupattelli A, Hensing G, Nordeng H (2017) Consumption of alcohol during pregnancy—a multinational European study. Women Birth. CrossRefPubMedGoogle Scholar
  21. McEwen BS, Gianaros PJ (2010) Central role of the brain in stress and adaptation: links to socioeconomic status, health, and disease. Ann N Y Acad Sci 1186:190–222. CrossRefPubMedPubMedCentralGoogle Scholar
  22. Melchior M, Chollet A, Glangeaud-Freudenthal N et al (2015) Tobacco and alcohol use in pregnancy in France: the role of migrant status: the nationally representative ELFE study. Addict Behav 51:65–71. CrossRefPubMedGoogle Scholar
  23. Metzger BE (2007) Long-term outcomes in mothers diagnosed with gestational diabetes mellitus and their offspring. Clin Obstet Gynecol 50:972–979. CrossRefPubMedGoogle Scholar
  24. Missinne S, Bracke P (2012) Depressive symptoms among immigrants and ethnic minorities: a population based study in 23 European countries. Soc Psychiatry Psychiatr Epidemiol 47:97–109. CrossRefPubMedGoogle Scholar
  25. Moullan Y, Jusot F (2014) Why is the ‘healthy immigrant effect’ different between European countries? Eur J Public Health 24:80–86. CrossRefPubMedGoogle Scholar
  26. Ng M, Freeman MK, Fleming TD et al (2014) Smoking prevalence and cigarette consumption in 187 countries, 1980–2012. JAMA 311:183–192. CrossRefPubMedGoogle Scholar
  27. OECD (2014) Foreign-born unemployment - OECD Data. In: the OECD.
  28. OECD (2017) Immigrant integration. In: understanding the socio-economic divide in Europe. OECD Publishing, pp 22–25Google Scholar
  29. United Nations, Department of Economic and Social Affairs, OECD (2013) World Migration in Figures.
  30. Rechel B (2011) Migration and health in the European Union. McGraw-Hill Education, MaidenheadGoogle Scholar
  31. Rechel B, Mladovsky P, Ingleby D et al (2013) Migration and health in an increasingly diverse Europe. The Lancet 381:1235–1245. CrossRefGoogle Scholar
  32. Reeske A, Spallek J, Razum O (2009) Changes in smoking prevalence among first- and second-generation Turkish migrants in Germany—an analysis of the 2005 Microcensus. Int J Equity Health 8:26. CrossRefPubMedPubMedCentralGoogle Scholar
  33. Saurel-Cubizolles M-J, Saucedo M, Drewniak N et al (2012) Santé périnatale des femmes étrangères en France. Bull Épidémiologique Hebd 2:3–4Google Scholar
  34. Vandentorren S, Bois C, Pirus C et al (2009) Rationales, design and recruitment for the Elfe longitudinal study. BMC Pediatr 9:58. CrossRefPubMedPubMedCentralGoogle Scholar
  35. Williams JF, Smith VC, Abuse the COS (2015) Fetal Alcohol Spectr Disord. Pediatrics 136:e1395–e1406. CrossRefPubMedGoogle Scholar

Copyright information

© Swiss School of Public Health (SSPH+) 2018

Authors and Affiliations

  • Fabienne El-Khoury Lesueur
    • 1
    Email author
  • Anne-Laure Sutter-Dallay
    • 2
    • 3
  • Lidia Panico
    • 4
  • Elie Azria
    • 5
    • 6
  • Judith Van der Waerden
    • 1
  • Nolwenn Regnault Vauvillier
    • 7
  • Marie-Aline Charles
    • 8
  • Maria Melchior
    • 1
  1. 1.Department of Social Epidemiology, Institut Pierre Louis d’Epidémiologie et de Santé Publique IPLESPINSERM, Sorbonne UniversitéParisFrance
  2. 2.University of BordeauxBordeauxFrance
  3. 3.Team Pharmacoepidemiology, Bordeaux Population Health Research CenterUniversity of Bordeaux, Inserm, UMR 1219BordeauxFrance
  4. 4.French Institute for Demographic Studies (INED)ParisFrance
  5. 5.Obstetrical, Perinatal and Pediatric Epidemiology Team (EPOPé), Epidemiology and Biostatistics Sorbonne Paris Cité CenterINSERM, UMR 1153, DHU Risk in PregnancyParisFrance
  6. 6.Department of Obstetrics, Groupe Hospitalier Paris Saint JosephParis Descartes UniversityParisFrance
  7. 7.Department of Non-communicable Diseases and TraumaSanté Publique FranceSaint-MauriceFrance
  8. 8.Early ORigin of the Child’s Health and Development Team (ORCHAD), Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS)INSERM, UMR1153, Paris Descartes University, FranceParisFrance

Personalised recommendations