Brenne S, David Matthias, Borde T, Breckenkamp J, Razum O
Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum Klinik für Gynäkologie, Augustenburger Platz 1, 13353, Berlin, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2015 Jun;58(6):569-76. doi: 10.1007/s00103-015-2141-6.
About 20% of the population in Germany has a migration background (1st generation: immigrated themselves; 2nd generation: offspring of immigrants), which can be associated with health differentials. We assessed whether differentials in uptake of antenatal care (ANC) observed in earlier studies still persist today.
Data collection in 3 obstetric hospitals in Berlin, Germany, over a 1-year period 2011/2012. We conducted standardised interviews before delivery and linked the data to routinely collected perinatal data and to data from participants' antenatal cards. We checked for confounders using regression models.
Of the 7100 study participants (response 89.6%), 57.9% had a migration background. First ANC attendance occurred in pregnancy weeks 3-19 in 92.1% of 1st generation immigrants vs. 97.8% of non-immigrants (mean week of first attendance: 1st generation immigrants with residence < 5 years: 13.0; 5+ years: 9.9; non-immigrants 9.7). A low ANC utilisation with ≤ 5 visits was found in 644 women (9.1%). Among the non-immigrants there were 7.1% low users, among 1st generation immigrants 11.8% (among women with no German language skills 33.0%, however). Uptake of non-medical support measures was lower among women with migration background.
In our sample from Berlin, migration background had little effect on ANC uptake. Neither own migration nor low acculturation were independent risk factors for late onset or low utilisation of ANC. However, a small subgroup of women with a short duration of residence in Germany and with German language problems had a lower chance of timely onset and sufficient participation in ANC. This group needs special attention.
德国约20%的人口有移民背景（第一代：自己移民；第二代：移民的后代），这可能与健康差异有关。我们评估了早期研究中观察到的产前护理（ANC）接受情况差异如今是否仍然存在。
2011年/2012年期间，在德国柏林的3家产科医院进行数据收集。我们在分娩前进行标准化访谈，并将数据与常规收集的围产期数据以及参与者产前卡片的数据相链接。我们使用回归模型检查混杂因素。
在7100名研究参与者中（应答率89.6%），57.9%有移民背景。92.1%的第一代移民在怀孕第3 - 19周首次接受ANC，而非移民为97.8%（首次就诊的平均孕周：居住时间<5年的第一代移民为13.0周；5年以上为9.9周；非移民为9.7周）。644名女性（9.1%）的ANC利用率较低，就诊次数≤5次。在非移民中，低利用率者占7.1%，第一代移民中占11.8%（然而，在没有德语技能的女性中占33.0%）。有移民背景的女性对非医疗支持措施的接受度较低。
在我们来自柏林的样本中，移民背景对ANC接受情况影响不大。自身移民和低文化适应程度都不是ANC开始较晚或利用率低的独立危险因素。然而，一小部分在德国居住时间短且有德语问题的女性及时开始并充分参与ANC的机会较低。这一群体需要特别关注。
