Vol.:(0123456789) 1 3 Arch Gynecol Obstet (2018) 297:313–322 https://doi.org/10.1007/s00404-017-4574-7 MATERNAL-FETAL MEDICINE Obstetric care quality indicators and outcomes based on the degree of acculturation of immigrants—results from a cross‑sectional study in Berlin Matthias David 1  · Theda Borde 2  · Silke Brenne 2  · Babett Ramsauer 3  · Larry Hinkson 4  · Wolfgang Henrich 4  · Oliver Razum 5  · Jürgen Breckenkamp 5   Received: 30 August 2017 / Accepted: 19 October 2017 / Published online: 25 October 2017 © Springer-Verlag GmbH Germany 2017 Results In summary, 7100 women were available for the survey (response rate of 89.6%) of which 3765 (53%) had a migration background. The probability of low acculturation is signifcantly (p < 0.001) associated with a lower level of German knowledge, a shorter period of residence, and lower education. Pregnant women with a low acculturation also had a signifcantly greater chance of having the frst booking visit after 9 weeks of pregnancy and fewer ultrasound exami- nations during pregnancy. There is no signifcant diference depending on the degree of acculturation for the frequency of elective and emergency cesarean sections. The results of the logistic regression analyses for the examination of possible relationships between the degree of acculturation and obstetric parameters show no signifcant diferences for prematurity, 5 min.-Apgar values > 7, arterial umbilical cord pH values > 7.00 and admissions to the neonatal unit. Conclusions In Berlin, among migrant women a low degree of acculturation may have an unfavorable efect on the utilization of pregnancy care provision. However, there were no relevant diferences in obstetric outcome parameters in relation to the degree of acculturation within the migrant population of Berlin. Keywords Immigration · Perinatal outcomes · Acculturation · Obstetrics · Latino paradox Introduction Economic and military disputes worldwide have created a signifcant increase in migration to western countries. According to data published in September 2016 from the German Federal Statistical Ofce, 81.4 million people live in Germany of which 17.2 million (21.2%) have a migration background (defned as self-migrated or direct descendant Abstract Hypothesis Acculturation is a complex, multidimensional process involving the integration of the traditional norms, values, and lifestyles of a new cultural environment. It is, however, unclear what impact the degree of acculturation has on obstetric outcomes. Methods Data collection was performed in 2011 and 2012 at three obstetric tertiary centers in Berlin, Germany. Standardized interviews (20–30 min.) were performed with support of evaluated questionnaires. The primary collected data were then linked to the perinatal data recorded at the individual clinics provided from the obstetric centers which correspond with the routinely centralized data collected for quality assurance throughout Germany. The questionnaire included questions on sociodemographic, health care, and migrant-related aspects. Migrant women and women with a migration background were assessed using the Frankfurt Acculturation Scale, a one-dimensional measurement tool to assess the degree of acculturation (15 items on language and media usage as well as integration into social networks). * Matthias David matthias.david@charite.de 1 Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Klinik für Gynäkologie, Augustenburger Platz 1, 13353 Berlin, Germany 2 Alice Salomon Hochschule, Berlin, Germany 3 Vivantes Klinikum Neukölln, Klinik für Geburtsmedizin, Berlin, Germany 4 Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum und Campus Charité Mitte, Kliniken für Geburtsmedizin, Berlin, Germany 5 Fakultät für Gesundheitswissenschaften, AG Epidemiologie und International, Universität Bielefeld, Bielefeld, Germany