Moore Patricia D, Bay R Curtis, Balcazar Hector, Coonrod Dean V, Brady Jane, Russ Robert
College of Nursing, Arizona State University, Tempe, Arizona 85287, USA.
Matern Child Health J. 2005 Mar;9(1):35-47. doi: 10.1007/s10995-005-2449-1.
To investigate whether US-born infants of mothers of Mexican descent who were enrolled in Arizona's Newborn Intensive Care Program (NICP) received follow-up services (developmental clinic and community health nurse [(CHN)] home visits) at the rates similar to White non-Hispanic (WNH) infants. Socio-economic and health status characteristics were controlled using stepped regressions in order to assess the impact of each on service use.
This population-based study used retrospective data from the NICP administrative database that were linked to birth certificates for years 1994-1998. The study population was limited to Arizona-born infants; it included 7442 infants of WNH mothers, 2612 infants of US-born Mexican American (MA) mothers and 2872 infants of Mexico-born mothers. Four service use indicators were used in the analysis.
Both Hispanic infant subgroups were less likely to have a CHN visit by 6 months and by 1 year, and to average fewer CHN visits. A smaller percent attended the developmental clinic by age one. After controlling for language, demographics, health status, socio-economic characteristics, and mothers' prenatal care use, infants of US-born MA mothers had rates of use similar to WNH. However, even after controlling for the study variables, infants of Mexico-born mothers were less likely (OR = .83) to use the developmental clinic. Hispanics continued to lag behind in the use of services compared with WNHs. The disparity is not a function of ethnicity, but appears attributable to demographic and socio-economic characteristics. Infants who had a CHN visit were significantly more likely (OR = 2.51) to use the developmental clinic than those without a nurse visit. Infants whose mothers had inadequate prenatal care were less likely to use these follow-up services even after controlling for study variables.
Infants whose mothers had inadequate prenatal care should be targeted for more intense CHN visits. Infants of mothers born in Mexico may need additional support/assistance in using the developmental clinic.
调查参加亚利桑那州新生儿重症监护项目（NICP）的墨西哥裔母亲在美国出生的婴儿接受后续服务（发育诊所和社区健康护士[(CHN)]家访）的比例是否与非西班牙裔白人（WNH）婴儿相似。使用逐步回归控制社会经济和健康状况特征，以评估各因素对服务利用的影响。
这项基于人群的研究使用了NICP行政数据库中的回顾性数据，这些数据与1994 - 1998年的出生证明相关联。研究人群仅限于在亚利桑那州出生的婴儿；包括7442名WNH母亲的婴儿、2612名美国出生的墨西哥裔美国（MA）母亲的婴儿和2872名墨西哥出生的母亲的婴儿。分析中使用了四个服务利用指标。
两个西班牙裔婴儿亚组在6个月和1岁时接受CHN家访的可能性较小，且平均CHN家访次数较少。到1岁时，参加发育诊所的比例较小。在控制了语言、人口统计学、健康状况、社会经济特征和母亲的产前护理使用情况后，美国出生的MA母亲的婴儿的服务利用率与WNH婴儿相似。然而，即使在控制了研究变量后，墨西哥出生的母亲的婴儿使用发育诊所的可能性仍然较小（OR = 0.83）。与WNH婴儿相比，西班牙裔在服务利用方面仍然落后。这种差异不是种族的作用，而是似乎归因于人口统计学和社会经济特征。接受过CHN家访的婴儿使用发育诊所的可能性显著高于未接受护士家访的婴儿（OR = 2.51）。即使在控制了研究变量后，母亲产前护理不足的婴儿使用这些后续服务的可能性也较小。
母亲产前护理不足的婴儿应成为更密集CHN家访的目标对象。在墨西哥出生的母亲的婴儿在使用发育诊所方面可能需要额外的支持/帮助。
