美国印第安人和阿拉斯加原住民农村人口与农村白人在围产期和婴儿健康差距方面的趋势。

Trends in perinatal and infant health disparities between rural American Indians and Alaska natives and rural Whites.

作者信息

Baldwin Laura-Mae, Grossman David C, Murowchick Elise, Larson Eric H, Hollow Walter B, Sugarman Jonathan R, Freeman William L, Hart L Gary

机构信息

Department of Family Medicine, University of Washington, Seattle, WA 98195-4982, USA.

出版信息

Am J Public Health. 2009 Apr;99(4):638-46. doi: 10.2105/AJPH.2007.119735. Epub 2008 Aug 13.

DOI:10.2105/AJPH.2007.119735

PMID:18703453

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2661488/

Abstract

OBJECTIVES

We examined disparities in perinatal care, birth outcomes, and infant health between rural American Indian and Alaska Native (AIAN) persons and rural Whites over time.

METHODS

We compared perinatal and infant health measures for 217 064 rural AIAN births and 5 032 533 rural non-Hispanic White births.

RESULTS

Among American Indians and Alaska Natives, unadjusted rates of inadequate prenatal care (1985-1987, 36.3%; 1995-1997, 26.3%) and postneonatal death (1985-1987, 7.1 per 1000; 1995-1997, 4.8 per 1000) improved significantly. However, disparities between American Indians and Alaska Natives and Whites in adjusted odds ratios (AORs) of postneonatal death (1985-1987, AOR = 1.55; 95% confidence interval [CI] = 1.41, 1.71; 1995-1997, AOR = 1.46; 95% CI = 1.31, 1.64) and adjusted risk ratios (ARRs) of inadequate prenatal care (1985-1987, ARR = 1.67; 95% CI = 1.65, 1.69; 1995-1997, ARR = 1.84; 95% CI = 1.81, 1.87) persisted.

CONCLUSIONS

Despite significant decreases in inadequate prenatal care and postneonatal death among American Indians and Alaska Natives, additional measures are needed to close persistent health gaps for this group.

摘要

目的

我们研究了随着时间推移，美国印第安人和阿拉斯加原住民（AIAN）与美国农村白人在围产期护理、出生结局和婴儿健康方面的差异。

方法

我们比较了217064例美国印第安人和阿拉斯加原住民农村分娩以及5032533例非西班牙裔白人农村分娩的围产期和婴儿健康指标。

结果

在美国印第安人和阿拉斯加原住民中，未调整的产前护理不足率（1985 - 1987年，36.3%；1995 - 1997年，26.3%）和新生儿后期死亡率（1985 - 1987年，每1000例中有7.1例；1995 - 1997年，每1000例中有4.8例）显著改善。然而，美国印第安人和阿拉斯加原住民与白人在新生儿后期死亡的调整优势比（AOR）（1985 - 1987年，AOR = 1.55；95%置信区间[CI] = 1.41, 1.71；1995 - 1997年，AOR = 1.46；95% CI = 1.31, 1.64）和产前护理不足的调整风险比（ARR）（1985 - 1987年，ARR = 1.67；95% CI = 1.65, 1.69；1995 - 1997年，ARR = 1.84；95% CI = 1.81, 1.87）方面的差异仍然存在。