加拿大魁北克地区根据母亲出生地划分的低出生体重结局中的社会经济差异。
Socioeconomic disparities in low birth weight outcomes according to maternal birthplace in Quebec, Canada.
作者信息
Moore Spencer, Daniel Mark, Auger Nathalie
机构信息
School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.
出版信息
Ethn Health. 2009 Feb;14(1):61-74. doi: 10.1080/13557850802071132.
OBJECTIVE
Studies in the USA suggest that the association between maternal birthplace, socioeconomic status (SES), and low birth weight (LBW) can vary across different immigrant groups. Less is known outside the USA about these associations. Our study assesses the association of maternal birthplace and SES on the likelihood of LBW infants in Québec, Canada.
METHODS
Using 2000 Quebec birth registry data, logistic regression was used to examine differentials in LBW according to maternal birthplace and SES. Singleton infants born to Québec mothers (n=47,988) were grouped into nine regions based on maternal birthplace: (1) Canada; (2) the USA and western Europe; (3) eastern Europe; (4) Latin America; (5) the Caribbean; (6) Sub-Saharan Africa; (7) north Africa and Middle East; (8) South Asia; and (9) East Asia and Pacific. SES was classified into four categories according to maternal educational attainment: (1) low SES (<11 years); (2) medium-low SES (11-12 years); (3) medium-high SES (13-14 years); and (4) high SES (more than 14 years). Covariates included maternal age, gestational duration, and parity. LBW was defined as between 500 and 2499 g.
RESULTS
Compared to a LBW prevalence of 4.5 for Canadian-born mothers, South Asian- and Caribbean-born mothers had prevalence percentages of 9.2 and 8.2, respectively. After adjusting for SES and other covariates, the likelihood (odds ratio (OR), 95% confidence intervals (CI)) of LBW outcomes remained greater for South Asian- (OR 2.84; 95% CI, 1.90-4.24) and Caribbean-born mothers (OR 1.52; 95% CI 1.11-2.10). After pooling these two groups and testing for moderation by SES, we found that high SES immigrant mothers (OR 3.82; 95% CI 2.33-6.25) had a higher likelihood of LBW infants than low SES mothers (OR 2.00; 95% CI 1.22-3.33) compared to high SES Canadian-born mothers.
DISCUSSION
In Québec, the association between foreign-born status and LBW varies according to maternal birthplace.
目的
美国的研究表明，母亲出生地、社会经济地位（SES）与低出生体重（LBW）之间的关联在不同移民群体中可能有所不同。在美国以外地区，人们对这些关联了解较少。我们的研究评估了加拿大魁北克地区母亲出生地和SES与低出生体重婴儿可能性之间的关联。
方法
利用2000年魁北克出生登记数据，采用逻辑回归分析根据母亲出生地和SES来研究低出生体重的差异。魁北克母亲所生的单胎婴儿（n = 47,988）根据母亲出生地被分为九个地区：（1）加拿大；（2）美国和西欧；（3）东欧；（4）拉丁美洲；（5）加勒比地区；（6）撒哈拉以南非洲；（7）北非和中东；（8）南亚；（9）东亚和太平洋地区。SES根据母亲的教育程度分为四类：（1）低SES（<11年）；（2）中低SES（11 - 12年）；（3）中高SES（13 - 14年）；（4）高SES（>14年）。协变量包括母亲年龄、孕周和产次。低出生体重定义为500至2499克。
结果
与加拿大出生母亲的低出生体重患病率4.5%相比，南亚和加勒比地区出生的母亲患病率分别为9.2%和8.2%。在调整了SES和其他协变量后，南亚出生母亲（比值比（OR）2.84；95%置信区间（CI）1.90 - 4.24）和加勒比地区出生母亲（OR 1.52；95% CI 1.11 - 2.10）的低出生体重结局可能性仍然更高。将这两组合并并检验SES的调节作用后，我们发现与高SES加拿大出生母亲相比，高SES移民母亲（OR 3.82；95% CI 2.33 - 6.25）的低出生体重婴儿可能性高于低SES母亲（OR 2.00；
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