Maslovitz Sharon, Kupferminc Michael J, Lessing Joseph B, Many Ariel
Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Isr Med Assoc J. 2005 May;7(5):315-9.
Foreign workers in Israel are not covered by the comprehensive medical insurance that all Israelis receive. They have national insurance and injury-related coverage, which does not include routine pregnancy follow-up
To compare perinatal outcome between partially insured non-resident migrants in Israel and comprehensively insured Israeli women.
Parameters of perinatal outcome were compared between 16,012 Israeli and 721 foreign women living in Israel. Outcome measures included birth weight, distribution of gestational age at delivery, neonatal complications, cesarean section, neonatal intensive care unit admission, intrauterine fetal death rates, and duration of post-partum hospitalization.
Deliveries prior to 28 weeks gestation occurred more frequently among non-residents (1.3% vs. 0.6%, P < 0.001). Gestational diabetes and preeclamptic toxemia were significantly more prevalent among non-residents (3.2% vs. 1.9%, P < 0.05 and 4.9% vs. 3.1%, P < 0.05, respectively). The cesarean rates were 18% and 35% for residents and non-residents, respectively (P < 0.001), and the post-cesarean recovery period was longer among non-residents (4.8 vs. 3.6 days, P < 0.05). The mean birth weight was similar in the two groups (3,214 vs. 3,231 g), although macrosomia (>4,000 g) was more prevalent among non-residents, who also had higher rates of NICU admission ((9.6% vs. 8%, P < 0.05) and intrauterine fetal death (6.6/1,000 vs. 3.7/1,000, P < 0.05).
Non-resident parturients in Israel are more susceptible to an adverse perinatal outcome than their Israeli counterparts. We suggest that government subsidization of non-residents' health expenditures would reduce the differences in perinatal outcome between these two groups.
在以色列的外国工人未被纳入所有以色列人都能享受的全面医疗保险范围。他们有国家保险和与工伤相关的保险，但不包括常规孕期检查。
比较以色列部分参保的非居民移民与全面参保的以色列女性之间的围产期结局。
对16012名以色列女性和721名居住在以色列的外国女性的围产期结局参数进行比较。结局指标包括出生体重、分娩时孕周分布、新生儿并发症、剖宫产、新生儿重症监护病房入住率、宫内胎儿死亡率及产后住院时长。
孕周小于28周的分娩在非居民中更常见（1.3%对0.6%，P<0.001）。非居民中妊娠期糖尿病和先兆子痫更为普遍（分别为3.2%对1.9%，P<0.05；4.9%对3.1%，P<0.05）。居民和非居民的剖宫产率分别为18%和35%（P<0.001），非居民剖宫产术后恢复期更长（4.8天对3.6天，P<0.05）。两组的平均出生体重相似（3214克对3231克），尽管巨大儿（>4000克）在非居民中更常见，非居民的新生儿重症监护病房入住率（9.6%对8%，P<0.05）和宫内胎儿死亡率（6.6/1000对3.7/1000，P<0.05）也更高。
以色列的非居民产妇比以色列产妇更容易出现不良围产期结局。我们建议政府补贴非居民的医疗支出，这将减少两组之间围产期结局的差异。
