根据来源地区的差异：2004-2007 年德国围产儿数据库分析。
Stillbirth differences according to regions of origin: an analysis of the German perinatal database, 2004-2007.
机构信息
Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, PO Box 10 01 31, D-33501 Bielefeld, Germany.
出版信息
BMC Pregnancy Childbirth. 2011 Sep 21;11:63. doi: 10.1186/1471-2393-11-63.
BACKGROUND
Stillbirth is a sensitive indicator for access to, and quality of health care and social services in a society. If a particular population group e.g. migrants experiences higher rates of stillbirth, this might be an indication of social deprivation or barriers to health care. This study examines differences in risk of stillbirth for women of different regions of origin compared to women from Germany in order to identify high risk groups/target groups for prevention strategies.
METHODS
We used the BQS dataset routinely compiled to examine perinatal outcomes in Germany nationwide. Participation of hospitals and completeness of data has been about 98% in recent years. Data on all live births and stillbirths were obtained for the period 2004 to 2007 (N = 2,670,048). We calculated crude and stratified mortality rates as well as corresponding relative mortality risks.
RESULTS
A significantly elevated stillbirth rate was found for women from the Middle East and North Africa (incl. Turkey) (RR 1.34, CI 1.22-1.55). The risk was slightly attenuated for low SES. An elevated risk was also found for women from Asia (RR 1.18, CI 1.02-1.65) and from Mediterranean countries (RR 1.14, CI 0.93-1.28). No considerable differences either in use and timing of antenatal care or preterm birth and low birthweight were observed between migrant and non-migrant women. After stratification for light for gestational age, the relative risk of stillbirth for women from the Middle East/North Africa increased to 1.63 (95% CI 1.25-2.13). When adjusted for preterm births with low birthweight, women from Eastern Europe and the Middle East/North Africa experienced a 26% (43%) higher risk compared with women from Germany.
CONCLUSIONS
We found differences in risk of stillbirth among women from Middle East/North Africa, especially in association with low SES and low birthweight for gestational age. Our findings suggest a need for developing and evaluating socially and culturally sensitive health promotion and prevention programmes for this group. The findings should also stimulate discussion about the quality and appropriateness of antenatal and perinatal care of pregnant women and newborns with migrant backgrounds.
背景
死产是一个敏感的指标，可以反映一个社会获得医疗保健和社会服务的情况以及医疗保健和社会服务的质量。如果某个特定的人群群体（例如移民）的死产率较高，这可能表明他们面临社会剥夺或获得医疗保健的障碍。本研究旨在比较不同原籍地区的妇女与德国妇女之间死产风险的差异，以便确定高风险群体/目标群体，以制定预防策略。
方法
我们使用常规编制的 BQS 数据集来检查德国全国围产期结局。近年来，医院参与率和数据完整性约为 98%。我们获得了 2004 年至 2007 年期间所有活产儿和死产儿的数据（N=2,670,048）。我们计算了粗死亡率和分层死亡率以及相应的相对死亡率风险。
结果
我们发现，来自中东和北非（包括土耳其）的妇女的死产率显著升高（RR 1.34，95%CI 1.22-1.55）。社会经济地位较低的妇女的风险略有降低。来自亚洲（RR 1.18，95%CI 1.02-1.65）和地中海国家（RR 1.14，95%CI 0.93-1.28）的妇女的风险也有所升高。在移民和非移民妇女之间，无论是在产前护理的使用和时间、早产或低出生体重方面，都没有观察到明显的差异。在校正了胎龄较轻的情况后，来自中东/北非的妇女的死产相对风险增加到 1.63（95%CI 1.25-2.13）。当调整了伴有低出生体重的早产时，来自东欧和中东/北非的妇女与德国妇女相比，风险增加了 26%（43%）。
结论
我们发现，来自中东/北非的妇女之间的死产风险存在差异，尤其是与社会经济地位较低和胎龄较轻的低出生体重有关。我们的研究结果表明，需要为这一群体制定和评估社会和文化敏感的健康促进和预防计划。这些发现还应引发关于具有移民背景的孕妇和新生儿的产前和围产期护理的质量和适当性的讨论。
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