TY  - JOUR
PY  - 2019//
TI  - Postpartum self-inflicted injury, suicide, assault and homicide in relation to immigrant status in Ontario: a retrospective population-based cohort study
JO  - CMAJ open
A1  - Vigod, Simone N.
A1  - Arora, Serena
A1  - Urquia, Marcelo L.
A1  - Dennis, Cindy-Lee
A1  - Fung, Kinwah
A1  - Grigoriadis, Sophie
A1  - Ray, Joel G.
SP  - E227
EP  - E235
VL  - 7
IS  - 2
N2  - BACKGROUND: Intentional injury, including suicide and assault, is a leading cause of maternal morbidity and mortality. We aimed to determine whether immigrant and nonimmigrant women differ in their 1-year risk of intentional injury after birth. <br><br>METHODS: This population-based retrospective cohort study used administrative data from Ontario from 2002 to 2012. Risk of self-inflicted injury (self-harm or suicide), and injury inflicted by others (assault or homicide), were each analyzed within 1 year after delivery of a live-born infant for immigrant and nonimmigrant mothers. Relative risks (RRs) were adjusted for maternal age, parity, income, resource utilization and psychiatric history. <br><br>RESULTS: The study included 327 279 immigrant and 942 502 nonimmigrant mothers. Risk of self-inflicted injury was similar among immigrants and nonimmigrants (adjusted RR 0.91, 95% confidence interval [CI] 0.78-1.04), with no variation by duration of residence or refugee status. Immigrants were at lower risk than nonimmigrants for injury inflicted by others (adjusted RR 0.57, 95% CI 0.51-0.64); that risk was higher among refugees than among nonrefugee immigrants (adjusted RR 1.79, 95% CI 1.33-2.41), and it was higher among long-term (adjusted RR 2.27, 95% CI 1.76-2.91) and medium-term (adjusted RR 1.58, 95% CI 1.19-2.11) immigrants than among recent immigrants. Variability by country of origin was observed for both injury types. <br><br>INTERPRETATION: Immigrant mothers have a reported risk for self-inflicted injury after birth similar to that of their Canadian-born counterparts. The extent to which selective underreporting of intentional injury in immigrant women might explain our findings is a key consideration for future research.<br><br>Copyright 2019, Joule Inc. or its licensors.<p />  <p>Language: en</p>
LA  - en
SN  - 2291-0026
UR  - http://dx.doi.org/10.9778/cmajo.20180178
ID  - ref1
ER  -