National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
Ann Epidemiol. 2012 Mar;22(3):175-82. doi: 10.1016/j.annepidem.2011.12.005. Epub 2012 Jan 29.
To compare the risk of preterm and low birth weight among newborns from native and immigrant women and to assess the role of prenatal care in the association between the ethnic origin of the women and their reproductive outcomes.
Cross-sectional study of 21,708 women giving birth between 1997 and 2008 in a region of Spain. Multinomial logistic regression models were adjusted to evaluate associations between mother's area of origin and adverse reproductive outcomes and to assess the role of prenatal care in the occurrence of adverse reproductive results.
Our results indicate a worse prenatal control in immigrants than in natives. Very preterm birth (VPTB) and very low birth weight (VLBW) were greater among immigrants (odds ratio [OR], 1.78; 95% confidence interval [95% CI], 1.14-2.79 for VPTB and OR, 1.73; 95% CI, 0.89-3.33 for VLBW) but after adjustment for prenatal care the differences were substantially reduced (OR, 1.43; 95% CI 0.85-2.42 for VPTB and OR 1.15; 95% CI 0.53-2.52 for VLBW).
Given the positive impact of prenatal care on reproductive results, strategies to improve it among immigrant women should be implemented. The difference found in the direction of the association between area of origin and different categories of low birth weight and preterm suggest that very and moderate categories should be analyzed separately in immigrant studies.
比较本地和移民妇女所生新生儿的早产和低出生体重风险，并评估产前保健在妇女原籍国与其生殖结果之间的关联中的作用。
这是一项在西班牙一个地区 1997 年至 2008 年间分娩的 21708 名妇女的横断面研究。采用多项逻辑回归模型进行调整，以评估母亲原籍国与不良生殖结局之间的关联，并评估产前保健在不良生殖结果发生中的作用。
我们的结果表明，移民的产前控制较差。移民的极早产（VPTB）和极低出生体重（VLBW）发生率较高（比值比[OR]，1.78；95%置信区间[95%CI]，1.14-2.79 用于 VPTB 和 OR，1.73；95%CI，0.89-3.33 用于 VLBW），但在调整产前保健后，差异大大缩小（OR，1.43；95%CI 0.85-2.42 用于 VPTB 和 OR 1.15；95%CI 0.53-2.52 用于 VLBW）。
鉴于产前保健对生殖结果的积极影响，应针对移民妇女实施改善其产前保健的策略。原籍国与不同类别的低出生体重和早产之间关联方向的差异表明，在移民研究中应分别分析非常早产和中度早产类别。
