移民、第二代和第三代女性以及非移民的剖宫产率：德国柏林的前瞻性研究
Caesarean Section Frequency among Immigrants, Second- and Third-Generation Women, and Non-Immigrants: Prospective Study in Berlin/Germany.
作者信息
David Matthias, Borde Theda, Brenne Silke, Henrich Wolfgang, Breckenkamp Jürgen, Razum Oliver
机构信息
Charité University Medicine Berlin, Clinic for Gynaecology, Campus Virchow-Klinikum, Berlin, Germany.
Alice Salomon Hochschule Berlin-University of Applied Sciences, Berlin, Germany.
出版信息
PLoS One. 2015 May 18;10(5):e0127489. doi: 10.1371/journal.pone.0127489. eCollection 2015.
OBJECTIVE
The frequency of caesarean section delivery varies between countries and social groups. Among other factors, it is determined by the quality of obstetrics care. Rates of elective (planned) and emergency (in-labor) caesareans may also vary between immigrants (first generation), their offspring (second- and third-generation women), and non-immigrants because of access and language barriers. Other important points to be considered are whether caesarean section indications and the neonatal outcomes differ in babies delivered by caesarean between immigrants, their offspring, and non-immigrants.
METHODS
A standardized interview on admission to delivery wards at three Berlin obstetric hospitals was performed in a 12-month period in 2011/2012. Questions on socio-demographic and care aspects and on migration (immigrated herself vs. second- and third-generation women vs. non-immigrant) and acculturation status were included. Data was linked with information from the expectant mothers' antenatal records and with perinatal data routinely documented in the hospital. Regression modeling was used to adjust for age, parity and socio-economic status.
RESULTS
The caesarean section rates for immigrants, second- and third-generation women, and non-immigrant women were similar. Neither indications for caesarean section delivery nor neonatal outcomes showed statistically significant differences. The only difference found was a somewhat higher rate of crash caesarean sections per 100 births among first generation immigrants compared to non-immigrants.
CONCLUSION
Unlike earlier German studies and current studies from other European countries, this study did not find an increased rate of caesarean sections among immigrants, as well as second- and third-generation women, with the possible exception of a small high-risk group. This indicates an equally high quality of perinatal care for women with and without a migration history.
目的
剖宫产分娩的频率在不同国家和社会群体之间存在差异。除其他因素外，它还取决于产科护理的质量。由于获得医疗服务的机会和语言障碍，选择性（计划）剖宫产和急诊（分娩时）剖宫产的比例在移民（第一代）、其后代（第二代和第三代女性）和非移民之间也可能有所不同。其他需要考虑的重要问题是，移民、其后代和非移民通过剖宫产分娩的婴儿，剖宫产指征和新生儿结局是否存在差异。
方法
2011/2012年的12个月期间，在柏林的三家产科医院对进入产房的产妇进行了标准化访谈。问题包括社会人口统计学和护理方面、移民情况（本人移民与第二代和第三代女性与非移民）以及文化适应状况。数据与准妈妈的产前记录信息以及医院常规记录的围产期数据相关联。采用回归模型对年龄、产次和社会经济状况进行调整。
结果
移民、第二代和第三代女性以及非移民女性的剖宫产率相似。剖宫产分娩的指征和新生儿结局均未显示出统计学上的显著差异。唯一发现的差异是，与非移民相比，第一代移民每100例分娩中的急诊剖宫产率略高。
结论
与德国早期研究和其他欧洲国家的当前研究不同，本研究未发现移民以及第二代和第三代女性的剖宫产率增加，可能除了一小部分高危人群外。这表明有和没有移民史的女性围产期护理质量同样高。
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