Rising Disparities in Severe Adverse Birth Outcomes Among Haitians in Québec, Canada, 1981–2006

Perinatal health data for Haitians are scant. We evaluated adverse birth outcomes for Haitians in Québec, Canada. We analyzed
2,124,909 live births from 1981 to 2006. Haitian ethnicity was assessed using maternal birth country (Haiti, other Caribbean
country, other foreign country, Canada) and home language (Creole, French/English but Creole mother tongue, French/English,
other). Associations between ethnicity and preterm birth (PTB), low birth weight (LBW), and small-for-gestational-age (SGA)
birth were calculated. Adverse birth outcomes were more common among mothers with Haitian ethnicity. Relative to Canadian-born
mothers, odds for Haitian-born mothers were 4 times greater for extreme PTB (≤27 weeks), twice greater for very PTB (28–31 weeks),
and 25% higher for moderate PTB (32–36 weeks). Patterns were similar for SGA birth and severe cases of LBW. Despite overall
decreases LBW and SGA birth, relative and absolute inequalities increased over time. Perinatal health inequalities are increasing
for Haitian-born mothers.