与在海外出生的低风险女性相比，澳大利亚出生的低风险女性在分娩期间的产科干预率以及选定的孕产妇和围产期结局。
Rates of obstetric intervention during birth and selected maternal and perinatal outcomes for low risk women born in Australia compared to those born overseas.
作者信息
Dahlen Hannah G, Schmied Virginia, Dennis Cindy-Lee, Thornton Charlene
出版信息
BMC Pregnancy Childbirth. 2013 May 1;13:100. doi: 10.1186/1471-2393-13-100.
BACKGROUND
There are mixed reports in the literature about obstetric intervention and maternal and neonatal outcomes for migrant women born in resource rich countries. The aim of this study was to compare the risk profile, rates of obstetric intervention and selected maternal and perinatal outcomes for low risk women born in Australia compared to those born overseas.
METHOD
A population-based descriptive study was undertaken in NSW of all singleton births recorded in the NSW Midwives Data Collection between 2000-2008 (n=691,738). Risk profile, obstetric intervention rates and selected maternal and perinatal outcomes were examined.
RESULTS
Women born in Australia were slightly younger (30 vs 31 years), less likely to be primiparous (41% vs 43%), three times more likely to smoke (18% vs 6%) and more likely to give birth in a private hospital (26% vs 18%) compared to women not born in Australia. Among the seven most common migrant groups to Australia, women born in Lebanon were the youngest, least likely to be primiparous and least likely to give birth in a private hospital. Hypertension was lowest amongst Vietnamese women (3%) and gestational diabetes highest amongst women born in China (14%). The highest caesarean section (31%), instrumental birth rates (16%) and episiotomy rates (32%) were seen in Indian women, along with the highest rates of babies <10th centile (22%) and <3rd centile (8%). Lebanese women had the highest rates of stillbirth (7.2/1000). Similar trends were found in the different migrant groups when only low risk women were included.
CONCLUSION
The results suggest there are significant differences in risk profiles, obstetric intervention rates and maternal and neonatal outcomes between Australian-born and women born overseas and these differences are seen overall and in low risk populations. The finding that Indian women (the leading migrant group to Australia) have the lowest normal birth rate and high rates of low birth weight babies is concerning, and attention needs to be focused on why there are disparities in outcomes and on effective models of care that might improve outcomes for this population.
背景
文献中关于在资源丰富国家出生的移民妇女的产科干预措施以及孕产妇和新生儿结局的报道不一。本研究的目的是比较在澳大利亚出生的低风险妇女与海外出生的低风险妇女的风险状况、产科干预率以及选定的孕产妇和围产期结局。
方法
在新南威尔士州开展了一项基于人群的描述性研究，研究对象为2000年至2008年新南威尔士州助产士数据收集中记录的所有单胎分娩（n = 691,738）。研究了风险状况、产科干预率以及选定的孕产妇和围产期结局。
结果
与非澳大利亚出生的妇女相比，澳大利亚出生的妇女年龄稍小（30岁对31岁），初产妇比例较低（41%对43%），吸烟可能性高三倍（18%对6%），在私立医院分娩的可能性更高（26%对18%）。在澳大利亚七个最常见的移民群体中，黎巴嫩出生的妇女最年轻，初产妇比例最低，在私立医院分娩的可能性最小。越南妇女的高血压患病率最低（3%），中国出生的妇女妊娠期糖尿病患病率最高（14%）。印度妇女的剖宫产率最高（31%）、器械助产率最高（16%）和会阴切开率最高（32%），同时体重低于第10百分位数（22%）和低于第3百分位数（8%）的婴儿比例也最高。黎巴嫩妇女的死产率最高（7.2/1000）。当仅纳入低风险妇女时，在不同移民群体中也发现了类似趋势。
结论
结果表明，澳大利亚出生的妇女与海外出生的妇女在风险状况、产科干预率以及孕产妇和新生儿结局方面存在显著差异，这些差异在总体人群和低风险人群中均可见。印度妇女（澳大利亚主要的移民群体）正常出生率最低且低体重儿比例高这一发现令人担忧，需要关注结局存在差异的原因以及可能改善该人群结局的有效护理模式。
Zotero 插件