Gibson-Helm Melanie E, Teede Helena J, Cheng I-Hao, Block Andrew A, Knight Michelle, East Christine E, Wallace Euan M, Boyle Jacqueline A
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
Monash Health, Clayton, Victoria, Australia.
Birth. 2015 Jun;42(2):116-24. doi: 10.1111/birt.12159. Epub 2015 Apr 11.
The relationship between migration and pregnancy outcomes is complex, with little insight into whether women of refugee background have greater risks of adverse pregnancy outcomes than other migrant women. This study aimed to describe maternal health, pregnancy care, and pregnancy outcomes among migrant women from humanitarian and nonhumanitarian source countries.
Retrospective, observational study of singleton births, at a single maternity service in Australia 2002-2011, to migrant women born in humanitarian source countries (HSCs, n = 2,713) and non-HSCs (n = 10,606). Multivariable regression analysis assessed associations between maternal HSC-birth and pregnancy outcomes.
Compared with women from non-HSCs, the following were more common in women from HSCs: age < 20 years (0.6 vs 2.9% p < 0.001), multiparity (51 vs 76% p < 0.001), body mass index (BMI) ≥ 25 (38 vs 50% p < 0.001), anemia (3.2 vs 5.9% p < 0.001), tuberculosis (0.1 vs 0.4% p = 0.001), and syphilis (0.4 vs 2.5% p < 0.001). Maternal HSC-birth was independently associated with poor or no pregnancy care attendance (OR 2.5 [95% CI 1.8-3.6]), late first pregnancy care visit (OR 1.3 [95% CI 1.1-1.5]), and postterm birth (> 41 weeks gestation) (OR 2.5 [95% CI 1.9-3.4]). Stillbirth (0.8 vs 1.2% p = 0.04, OR 1.5 [95% CI 1.0-2.4]) and unplanned birth before arrival at the hospital (0.6 vs 1.2% p < 0.001, OR 1.3 [95% CI 0.8-2.1]) were more common in HSC-born women but not independently associated with maternal HSC-birth after adjusting for age, parity, BMI and relative socioeconomic disadvantage.
These findings suggest areas where women from HSCs may have additional needs in pregnancy compared with women from non-HSCs. Refugee-focused strategies to support engagement in pregnancy care and address maternal health needs would be expected to improve health outcomes in resettlement countries.
移民与妊娠结局之间的关系复杂，对于具有难民背景的女性是否比其他移民女性有更高的不良妊娠结局风险，了解甚少。本研究旨在描述来自人道主义和非人道主义来源国的移民女性的孕产妇健康、孕期保健及妊娠结局。
对2002年至2011年在澳大利亚一家产科服务机构出生的单胎婴儿进行回顾性观察研究，研究对象为出生在人道主义来源国（HSCs，n = 2713）和非人道主义来源国（n = 10606）的移民女性。多变量回归分析评估孕产妇出生于人道主义来源国与妊娠结局之间的关联。
与非人道主义来源国的女性相比，人道主义来源国的女性中以下情况更为常见：年龄<20岁（0.6%对2.9%，p<0.001）、多胎妊娠（51%对76%，p<0.001）、体重指数（BMI）≥25（38%对50%，p<0.001）、贫血（3.2%对5.9%，p<0.001）、结核病（0.1%对0.4%，p = 0.001）和梅毒（0.4%对2.5%，p<0.001）。孕产妇出生于人道主义来源国与孕期保健就诊不佳或未就诊（比值比[OR]2.5[95%置信区间（CI）1.8 - 3.6]）、首次孕期保健就诊延迟（OR 1.3[95%CI 1.1 - 1.5]）以及过期产（妊娠>41周）（OR 2.5[95%CI 1.9 - 3.4]）独立相关。死产（0.8%对1.2%，p = 0.04，OR 1.5[95%CI 1.0 - 2.4]）和入院前意外分娩（0.6%对1.2%，p<0.001，OR 1.3[95%CI 0.8 - 2.1]）在出生于人道主义来源国的女性中更为常见，但在调整年龄、胎次、BMI和相对社会经济劣势后，与孕产妇出生于人道主义来源国无独立关联。
这些发现表明，与人道主义来源国以外的女性相比，人道主义来源国的女性在孕期可能有更多额外需求。预计以难民为重点的支持参与孕期保健和满足孕产妇健康需求的策略将改善安置国的健康结局。
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