MacMullen Nancy J, Tymkow Catherine, Shen Jay J
Governors State University, University Park, IL, USA.
MCN Am J Matern Child Nurs. 2006 Jul-Aug;31(4):263-8. doi: 10.1097/00005721-200607000-00012.
To examine the relationship between race and adverse maternal outcomes in women with asthma.
This retrospective cohort study examined 11 adverse maternal outcomes across racial groups of 13,900 pregnant women with asthma (age 13 to > or = 40) who gave birth between 1998 and 1999. The data were abstracted from a national database, The National Inpatient Sample (NIS), available through Health Care and Utilization Project (HCUP) maintained and disseminated by the Agency for Healthcare Research and Quality (AHRQ). Maternal age and comorbidities were adjusted in multivariate analysis.
For women with asthma, African Americans were more likely than Whites to have preterm labor and infection of the amniotic cavity; Hispanic women had comparable outcomes with the exception that postdate pregnancy was less likely to be 42 weeks; and Asian/Pacific Islander women had a higher risk of having gestational diabetes and infection of the amniotic cavity.
As adverse maternal outcomes for women with asthma were higher in minorities, and as minorities have traditionally had more barriers to healthcare, the study results indicate that more effort needs to be made to educate nurses, consumers, and government officials about the potential adverse maternal outcomes of asthma during pregnancy. Public awareness may assist in overcoming the barriers to healthcare experienced by minorities.
研究哮喘女性患者的种族与不良孕产妇结局之间的关系。
这项回顾性队列研究调查了1998年至1999年间分娩的13900名年龄在13岁至40岁及以上的哮喘孕妇不同种族群体中的11种不良孕产妇结局。数据摘自一个国家数据库——国家住院患者样本(NIS),该数据库可通过医疗保健研究与质量局(AHRQ)维护和发布的医疗保健利用项目(HCUP)获取。在多变量分析中对产妇年龄和合并症进行了调整。
对于哮喘女性患者,非裔美国人比白人更易发生早产和羊膜腔感染;西班牙裔女性的结局与之相当,只是过期妊娠不太可能达到42周;亚太岛民女性患妊娠期糖尿病和羊膜腔感染的风险更高。
由于哮喘女性患者的不良孕产妇结局在少数族裔中更高,且少数族裔传统上在获得医疗保健方面面临更多障碍,研究结果表明,需要做出更多努力,向护士、消费者和政府官员宣传哮喘在孕期可能导致的不良孕产妇结局。提高公众意识可能有助于克服少数族裔在获得医疗保健方面遇到的障碍。