Ekeroma Alec J, Craig Elizabeth D, Stewart Alistair W, Mantell Colin D, Mitchell Ed A
Department of Obstetrics and Gynaecology, University of Auckland, Middlemore Hospital, Auckland, New Zealand.
Aust N Z J Obstet Gynaecol. 2004 Dec;44(6):541-4. doi: 10.1111/j.1479-828X.2004.00311.x.
Pacific women in New Zealand reside in areas of higher socioeconomic deprivation compared to women from other ethnic groups. Pacific women and their health are further disadvantaged because of genetic predisposition and sociocultural factors that cause ill-health. The correlations between pregnancy outcomes, risk factors and other health indices in Pacific women need evaluation.
To examine trends in preterm birth, small for gestational age (SGA) and late fetal death for Pacific women during 1980-2001 and to explore risk factors which make this group vulnerable to adverse birth outcome.
De-identified birth registration data from 1 189 120 singleton live births and 5775 stillbirths were analysed for 1980-2001. Outcomes of interest included preterm birth, SGA and late fetal death while explanatory variables included maternal ethnicity, age and NZ Deprivation Index decile. Trend analysis was undertaken for 1980-1994 and multivariate logistic regression was used to explore risk factors for 1996-2001.
Pacific women had the lowest rates of preterm birth and SGA when compared to Maori and European women. In addition, preterm birth rates underwent a non-significant 4% decline and SGA rates a 30% decline during 1980-1994. Although there has been a 49% decline in late fetal deaths during 1980-1994, the rate remained higher for Pacific women than for Maori and European/other women.
Despite residing in areas of high socioeconomic deprivation, which is associated with poor pregnancy outcomes for Maori and European/other women, Pacific women had better pregnancy outcomes, with lower preterm and SGA rates. The significant decline in rates of late fetal death during the past two decades is a cause for celebration; however, the rate remains higher for Pacific women than for other ethnic groups. Biological, cultural and social factors might explain the better pregnancy outcomes for Pacific women and these factors should be considered when developing future prevention programmes.
与其他族裔的女性相比，新西兰的太平洋岛裔女性居住在社会经济剥夺程度较高的地区。由于遗传易感性和导致健康问题的社会文化因素，太平洋岛裔女性及其健康状况更加不利。太平洋岛裔女性的妊娠结局、风险因素与其他健康指标之间的相关性需要评估。
研究1980 - 2001年期间太平洋岛裔女性早产、小于胎龄儿（SGA）和晚期胎儿死亡的趋势，并探讨使该群体易发生不良分娩结局的风险因素。
对1980 - 2001年期间1189120例单胎活产和5775例死产的匿名出生登记数据进行分析。感兴趣的结局包括早产、SGA和晚期胎儿死亡，而解释变量包括母亲的种族、年龄和新西兰剥夺指数十分位数。对1980 - 1994年进行趋势分析，并使用多因素逻辑回归来探讨1996 - 2001年的风险因素。
与毛利族和欧洲族女性相比，太平洋岛裔女性的早产和SGA发生率最低。此外，1980 - 1994年期间，早产率有4%的非显著性下降，SGA率下降了30%。尽管1980 - 1994年期间晚期胎儿死亡下降了49%，但太平洋岛裔女性的这一比率仍高于毛利族和欧洲族/其他族女性。
尽管居住在社会经济剥夺程度高的地区，而这与毛利族和欧洲族/其他族女性不良妊娠结局相关，但太平洋岛裔女性的妊娠结局更好，早产和SGA发生率更低。过去二十年中晚期胎儿死亡率的显著下降值得庆祝；然而，太平洋岛裔女性的这一比率仍高于其他族裔群体。生物学、文化和社会因素可能解释了太平洋岛裔女性更好的妊娠结局，在制定未来的预防计划时应考虑这些因素。
