Minsart Anne-Frederique, Liu Hau, Moffett Shannon, Chen Crystal, Ji Ninni
Department of Obstetrics and Gynecology, Shanghai United Family Hospital, 1139 Xianxia Lu, Changning District, Shanghai, 200336, People's Republic of China.
Matern Child Health J. 2017 Oct;21(10):1861-1866. doi: 10.1007/s10995-017-2347-3.
Introduction Immigrants from Western industrialized countries are rarely found in immigrant studies. Our primary objective was to calculate the rate of cesarean delivery, 5-min Apgar score <7, and preterm birth among Chinese and Western women. Our secondary objective was to examine whether there are significant differences in terms of risk factors between Western immigrants who chose to deliver in their country of citizenship compared to those who chose to deliver in China. Methods Single-center retrospective cohort study in Shanghai, China. Multivariate logistic regression models used delivery outcome, and place of delivery (China vs. country of citizenship) as outcome variables. Results Preterm birth occurred at a rate of 3.82% among Chinese citizens, 4.12% among Chinese-born Western citizens, and 6.54% among non-Chinese-born Western citizens. After adjustment, preterm birth <37 weeks was more frequent among non-Chinese-born Western citizens compared with Chinese citizens, with an odds ratio of 1.82 (Confidence Interval 1.20-2.78), p = 0.005. Variables statistically associated with giving birth in China were maternal age ≥35 years and being Chinese-born Western, as well as the absence of medical or obstetrical conditions. Discussion Western immigrants have overall good obstetrical outcomes in China, and this could be partly explained by selective immigration, but also by the Salmon bias, as women with risk factors tend to return to their country of citizenship for the delivery. However, the preterm birth rate was higher among Western women than in their Chinese counterparts, and further research is needed.
在移民研究中很少能发现来自西方工业化国家的移民。我们的主要目标是计算中国女性和西方女性的剖宫产率、5分钟阿氏评分<7以及早产率。我们的次要目标是研究选择在其国籍所在国分娩的西方移民与选择在中国分娩的西方移民在风险因素方面是否存在显著差异。方法：在中国上海进行单中心回顾性队列研究。多变量逻辑回归模型将分娩结局和分娩地点（中国与国籍所在国）作为结局变量。结果：中国公民的早产率为3.82%，在中国出生的西方公民为4.12%，非中国出生的西方公民为6.54%。调整后，非中国出生的西方公民的<37周早产发生率高于中国公民，比值比为1.82（置信区间1.20 - 2.78），p = 0.005。与在中国分娩有统计学关联的变量包括产妇年龄≥35岁、在中国出生的西方身份以及无医疗或产科疾病。讨论：西方移民在中国总体上有良好的产科结局，这部分可以通过选择性移民来解释，但也存在“萨蒙偏倚”，因为有风险因素的女性往往会返回其国籍所在国分娩。然而，西方女性的早产率高于中国女性，需要进一步研究。
