An area-based study in central Italy
Sara Farchi, A. Polo, D. Di Lallo (Italy)
Introduction. Italy recently dealt with a consistent migration flow. In Lazio region (main city Rome), a 45% of increase of fertile immigrant women was observed between years 2003 and 2007. This issue represents a challenge for health services because migrant women have more difficulties in access to care.
This study describes characteristics of migrant women making induced legal abortions.
Materials and methods. Data were extracted by the mandatory legal induced abortion file containing for each induced abortion performed in Lazio region information on reproductive history, socio-demographic characteristics, gestational age of the woman asking for the interruption. Other information regards the urgency for the abortion, the institution that certificated the interruption, and its characteristics.
Descriptive analyses and a multivariate logistic models were performed to estimate the risk of multiple induced abortion and the risk of late interruption (at 11-12 weeks of gestation) among migrant women in contrast to Italian ones, including only legal induced abortions performed within 90 days of gestation. Potential confounders included in the models were: woman age, education, marital status and parity.
Results. In 2007, in Lazio region 14242 abortions within 90 days have been performed. An increasing trend in foreign women induced abortions was observed in recent years: in 2007, the 42.6% of the interruptions were asked by a foreign woman, while in 1987 they represented the 5.4%. At the same time, a induced abortion decreased among Italian women. The 77% of the foreign women were born in non industrialised countries (Romania, Peru and Ukraine). 70% of the migrant women were aged 20-34 years, while Italian ones tended older. A larger proportion of multiple induced abortions and late interruptions were observed among foreign women than Italians. Multivariate logistic models showed that women from non industrialised country had 2,5 times the risk of multiple abortion than the Italians (OR=2.49; 95% CI 95%: 2.29-2.71), while no difference between Italians and women coming from industrialised countries was observed. Moreover, women from non industrialised countries had higher risk of late interruptions than Italians (OR=1.62; CI 95%: 1.49-1.76).
Conclusion. This descriptive study highlights the need of preventive interventions aimed at improving the quality of reproductive care for these women.