Length of time in Australia was not collected by the maternity service,
but this informationwould have contributed important insights regarding
the effect of acculturation on pregnancy care attendance and
pregnancy outcomes. Potential cultural and language barriers could
contribute to over- or under-representation of variables reliant on
self-report—e.g. spousal relationships. BMI was only routinely collected
from partway through the study period; consequently, sample size for
multivariable analysis was reduced. Some outcomes, such as stillbirth,
were uncommon, limiting the conclusions that can be drawn.
Nevertheless, strengths of the present study include a rigorous, objectivemethod
to select current,major HSCs using national immigration
profiles. It also used pregnancy profiles for women born in non-HSCs
within the same world regions to identify health needs specific to
humanitarian migrants. The large sample size enabled multivariable
analysis, including adjustment for a marker of social disadvantage.