van den Akker Thomas, van Roosmalen Jos
Department of Obstetrics, Leiden University Medical Center, Postbus 9600, 2300RC Leiden, The Netherlands.
Department of Obstetrics, Leiden University Medical Center, Postbus 9600, 2300RC Leiden, The Netherlands; Athena Institute, Faculty of Earth and Life Sciences, VU University, De Boelelaan 1085-1087, 1081HV Amsterdam, The Netherlands.
Best Pract Res Clin Obstet Gynaecol. 2016 Apr;32:26-38. doi: 10.1016/j.bpobgyn.2015.08.016. Epub 2015 Sep 10.
Among migrants in high-income countries, maternal mortality and severe morbidity generally occur more frequently as compared to host populations. There is marked variation between groups of migrants and host countries, with much elevated risks in some groups and no elevated risk at all in others. Those without a legal resident permit are most vulnerable. A reason for these elevated risks could be a different risk profile in migrants, but risk factors are unevenly distributed and not always present. Another reason is substandard care, which is identified more frequently in migrants, and comprises patient delays, for example, due to a lack of knowledge about the health system in the host country, and health worker delays, often compounded by communication barriers. Improvements in family planning and antenatal services are needed, and audits and confidential enquiries should be extended to include maternal morbidity and ethnic background. This requires scientific and political efforts.
在高收入国家的移民群体中，与东道国人口相比，孕产妇死亡率和严重发病率通常更为常见。移民群体与东道国之间存在显著差异，一些群体的风险大幅升高，而另一些群体则根本没有风险升高的情况。那些没有合法居住许可的人最为脆弱。这些风险升高的一个原因可能是移民的风险状况不同，但风险因素分布不均且并非总是存在。另一个原因是医疗服务不合格，这在移民中更常被发现，包括患者延误，例如由于对东道国卫生系统缺乏了解，以及医护人员延误，这往往因沟通障碍而加剧。需要改善计划生育和产前服务，审计和保密调查应扩大到包括孕产妇发病率和种族背景。这需要科学和政治方面的努力。
