Gann P, Nghiem L, Warner S
Department of Family and Community Medicine, University of Massachusetts Medical Center, Worcester 01655.
Am J Public Health. 1989 Sep;79(9):1251-7. doi: 10.2105/ajph.79.9.1251.
This study describes the perinatal characteristics of Cambodian refugees in Massachusetts. Data were abstracted from the records of 452 consecutive pregnancies among Cambodian women and 110 low-income Whites receiving obstetrical services at the same clinic and hospital in Lowell, Massachusetts. Pregnancies of Cambodian women were marked by a higher proportion of older mothers, grand multiparas, previous adverse birth outcomes, and short interpregnancy intervals. We identified maternal anemia (29.9 percent with hemoglobin less than 110 g/L) and inadequate utilization of prenatal care (32.3 percent with first visit in the 3rd trimester) as possible risk factors for the Cambodians. The prevalence of primary cesarean birth was only 6.3 percent in the Cambodians, compared to 15.6 percent in the comparison group, largely due to the infrequent occurrence of prolonged labor among multiparas. Despite the prominence of several risk factors for adverse birth outcomes in this population, major pregnancy complications were less common and the prevalence of low birthweight (6.4 percent) was close to the state average. Logistic regression analysis of risk factors for low birthweight identified young maternal age and short stature as the strongest factors operative in this community. Many of our findings are consistent with a strong cultural emphasis on managing the size of the baby to avoid a difficult labor and delivery.
本研究描述了马萨诸塞州柬埔寨难民的围产期特征。数据取自马萨诸塞州洛厄尔同一诊所和医院中452名柬埔寨妇女连续妊娠的记录以及110名接受产科服务的低收入白人的记录。柬埔寨妇女的妊娠特点是高龄母亲、多产孕妇、既往不良分娩结局以及较短的妊娠间隔比例较高。我们确定孕妇贫血(血红蛋白低于110g/L的占29.9%)和产前保健利用不足(孕晚期首次就诊的占32.3%)为柬埔寨人的可能风险因素。柬埔寨人原发性剖宫产的发生率仅为6.3%,而对照组为15.6%,这主要是因为经产妇很少出现产程延长。尽管该人群中存在多种不良分娩结局的风险因素,但主要的妊娠并发症较少见,低出生体重的发生率(6.4%)接近该州平均水平。对低出生体重风险因素的逻辑回归分析确定,年轻产妇年龄和身材矮小是该社区中作用最强的因素。我们的许多研究结果与一种强烈的文化观念一致,即强调控制婴儿大小以避免难产和分娩困难。