Public health, policy, and clinical interventions to improve perinatal care for migrant women and infants in high-income countries: a systematic reviewResearch in context

Background: Migrant women who are pregnant or postpartum and their infants are often at increased risk of poorer perinatal outcomes compared to host country populations. This review aimed to identify public health, policy, and clinical interventions to improve maternity care for migrant women and their infants in high-income countries (HICs). Methods: In this systematic review we searched EMBASE, EMCARE, MEDLINE and PsycINFO, CENTRAL, Scopus, CINAHL Plus, Web of Science, and grey literature from inception to 13th March 2024, with no language or date restrictions (PROSPERO: CRD42022380678). Interventional and observational studies assessing the effectiveness of any intervention to improve perinatal care for migrant women and their infants in HICs delivered in the pregnancy, peripartum, or postpartum period (up to one year after birth) were included. Quantitative outcomes were extracted. Qualitative studies were excluded. The main outcomes of interest were preterm birth, birthweight, and appointment attendance. Quantitative synthesis was conducted using Harvest plots and binomial exact calculations. Findings: 15,689 records were retrieved, 29 studies comprising data from 16,763,837 women were included. 22 studies (75.9%) included multiple interventions. Five interventions had strong evidence of effectiveness. Two clinical interventions: 100.0% of studies including specialist multidisciplinary teams improved one or more of the main outcomes of interest, namely preterm birth, birthweight, and appointment attendance (95% confidence interval 73.5–100.0%; p