Korenbrot Carol C., Affonso Dyanne D., Mayberry Linda J., Paul Steven M.
Institute for Health Policy Studies and the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), and Program Evaluation Consultant on the Malama Na Wahine Hapai project.
Asian Am Pac Isl J Health. 1994 Summer;2(3):181-194.
PURPOSE. This study examines ethnic-specific differences in associations of inadequate use of prenatal care with poor birthweight outcomes to determine whether ethnic specific improvements in the use of prenatal care in a rural district could potentially reduce infant morbidity or mortality there. METHODS. Data from 1988 to 1990 birth certificates of the state of Hawaii were used to study Filipino, Hawaiian and Japanese births. Stratified multivariate logistic regression analyses of the association of inadequate use of prenatal care visits with low birthweight were performed for each group adjusting for potentially confounding sociodemographic risk characteristics. SUMMARY OF IMPORTANT FINDINGS. Results indicate that the adjusted odds of low birthweight for the Hawaiians in the rural district with inadequate amounts of prenatal care visits were higher than for those with adequate visits (OR 2.1; CI 1.4, 3.1) and those relative odds were higher than for Hawaiians in the rest of the state (OR 1.2; CI 1.1, 1.5). Births to Japanese women in the area had a similar pattern (OR 2.3, CI 0.97, 5.6; rest of state OR 1.2, CI 0.98, 1.5), but the ratios were not statistically significant. Births to Filipino women did not have the same pattern (OR 0.73, CI 0.34, 1.6; rest of state OR 1.4, CI 1.2, 1.6). MAJOR CONCLUSIONS. There is substantial heterogeneity in the associations of inadequate care use with poor birthweight outcomes in different groups of Asian Pacific women and in different locations in which they settle. RELEVANCE TO ASIAN AND PACIFIC ISLANDER AMERICAN POPULATIONS. Communities need to determine the associations of poor birth outcomes with poor prenatal care usage of Asian Pacific women to determine whether ethnic specific improvements in prenatal care could potentially improve such outcomes in their areas. KEY WORDS. pregnancy, health services research, outcome and process assessment (health care), regression analysis (logistic models), low birth weight, patient compliance.
目的。本研究探讨产前护理使用不足与低出生体重结局之间关联的种族特异性差异，以确定农村地区产前护理使用方面的种族特异性改善是否有可能降低当地婴儿的发病率或死亡率。方法。使用夏威夷州1988年至1990年出生证明的数据来研究菲律宾裔、夏威夷裔和日本裔的出生情况。对每组进行产前护理就诊使用不足与低出生体重之间关联的分层多变量逻辑回归分析，并对潜在的混杂社会人口学风险特征进行调整。重要研究结果总结。结果表明，农村地区产前护理就诊次数不足的夏威夷人出生低体重的调整后比值高于就诊次数充足者（比值比2.1；置信区间1.4, 3.1），且这些相对比值高于该州其他地区的夏威夷人（比值比1.2；置信区间1.1, 1.5）。该地区日本女性的分娩情况有类似模式（比值比2.3，置信区间0.97, 5.6；该州其他地区比值比1.2，置信区间0.98, 1.5），但这些比值无统计学显著性。菲律宾女性的分娩情况没有相同模式（比值比0.73，置信区间0.34, 1.6；该州其他地区比值比1.4，置信区间1.2, 1.6）。主要结论。不同亚太女性群体以及她们定居的不同地点，护理使用不足与低出生体重结局之间的关联存在很大异质性。与亚太裔美国人群体的相关性。社区需要确定亚太女性不良出生结局与产前护理使用不足之间的关联，以确定产前护理的种族特异性改善是否有可能改善其所在地区的此类结局。关键词。妊娠；卫生服务研究；结局与过程评估（卫生保健）；回归分析（逻辑模型）；低出生体重；患者依从性。
