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Objectives: To compare maternal characteristics and birth outcomes of Mexico-born and native-born mothers in the United States and those of North African mothers living in France and Belgium to French and Belgian nationals., Methods: We examined information from single live birth certificates for 285,371 Mexico-born and 3,131,632 U.S.-born mothers (including 2,537,264 U.S.-born White mothers) in the United States, 4,623 North African and 103,345 Belgian mothers in Belgium, and a French national random sample consisting of 632 North African and 11,185 French mothers. The outcomes were mean birthweight, low birthweight, and preterm births. Differences between native/nationals and foreign-born mothers in each country were assessed in bivariate and multivariate analyses controlling for maternal risk factors., Results: The adjusted odds for low birthweight were lower for immigrants than native/nationals by 32% in the United States, by 32% in Belgium, and by 30% in France. The adjusted odds for preterm births were lower for immigrants compared with native/nationals by 11% in the United States and by 23% in Belgium. In France, the odds for preterm births were comparable for immigrants and naturalized mothers. Infants of immigrant mothers also had higher mean birthweights in all three countries., Conclusion: Despite their disadvantaged status, Mexico-born and North African-born women residing in the United States, France, and Belgium show good birth outcomes. These cannot be explained solely by traditional risk factors. Protective factors and selective migration may offer further clues.

A retrospective survey on a representative sample of births in France in 1972 relating to more than 11000 women showed the amount of perinatal pathology among immigrants as compared with French women: a higher rate of foetal or neonatal distress, a three to four times higher stillbirth rate among Portuguese and North African women, a prematurity rate more than twice as higher among North African women. When differences in parity and socio-cultural level between immigrant and French women were allowed for, there remained a higher rate of perinatal pathology among immigrants. Prenatal care was also more often inadequate among immigrants, even when taking into account their low socio-cultural standard. Attitude towards prenatal care was highly influenced by the level of adaptation in France. But, even with equal prenatal care, perinatal pathology was higher among immigrant women: being an immigrant is a risk factor in itself.