David Matthias, Borde Theda, Brenne Silke, Ramsauer Babett, Hinkson Larry, Henrich Wolfgang, Razum Oliver, Breckenkamp Jürgen
Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Klinik für Gynäkologie, Augustenburger Platz 1, 13353, Berlin, Germany.
Alice Salomon Hochschule, Berlin, Germany.
Arch Gynecol Obstet. 2018 Feb;297(2):313-322. doi: 10.1007/s00404-017-4574-7. Epub 2017 Oct 25.
Acculturation is a complex, multidimensional process involving the integration of the traditional norms, values, and lifestyles of a new cultural environment. It is, however, unclear what impact the degree of acculturation has on obstetric outcomes.
Data collection was performed in 2011 and 2012 at three obstetric tertiary centers in Berlin, Germany. Standardized interviews (20-30 min.) were performed with support of evaluated questionnaires. The primary collected data were then linked to the perinatal data recorded at the individual clinics provided from the obstetric centers which correspond with the routinely centralized data collected for quality assurance throughout Germany. The questionnaire included questions on sociodemographic, health care, and migrant-related aspects. Migrant women and women with a migration background were assessed using the Frankfurt Acculturation Scale, a one-dimensional measurement tool to assess the degree of acculturation (15 items on language and media usage as well as integration into social networks).
In summary, 7100 women were available for the survey (response rate of 89.6%) of which 3765 (53%) had a migration background. The probability of low acculturation is significantly (p < 0.001) associated with a lower level of German knowledge, a shorter period of residence, and lower education. Pregnant women with a low acculturation also had a significantly greater chance of having the first booking visit after 9 weeks of pregnancy and fewer ultrasound examinations during pregnancy. There is no significant difference depending on the degree of acculturation for the frequency of elective and emergency cesarean sections. The results of the logistic regression analyses for the examination of possible relationships between the degree of acculturation and obstetric parameters show no significant differences for prematurity, 5 min.-Apgar values > 7, arterial umbilical cord pH values > 7.00 and admissions to the neonatal unit.
In Berlin, among migrant women a low degree of acculturation may have an unfavorable effect on the utilization of pregnancy care provision. However, there were no relevant differences in obstetric outcome parameters in relation to the degree of acculturation within the migrant population of Berlin.
文化适应是一个复杂的多维度过程，涉及新文化环境中传统规范、价值观和生活方式的融合。然而，尚不清楚文化适应程度对产科结局有何影响。
2011年和2012年在德国柏林的三个产科三级中心进行了数据收集。在经过评估的问卷支持下进行标准化访谈（20 - 30分钟）。然后将收集的主要数据与各诊所记录的围产期数据相联系，这些数据由产科中心提供，与德国全国为质量保证而常规集中收集的数据相对应。问卷包括有关社会人口统计学、医疗保健和移民相关方面的问题。使用法兰克福文化适应量表对移民妇女和有移民背景的妇女进行评估，该量表是一种一维测量工具，用于评估文化适应程度（关于语言和媒体使用以及融入社交网络的15个项目）。
总之，7100名妇女可供调查（应答率为89.6%），其中3765名（53%）有移民背景。文化适应程度低的可能性与德语知识水平较低、居住时间较短和教育程度较低显著相关（p < 0.001）。文化适应程度低的孕妇在怀孕9周后首次预约就诊的可能性也显著更高，且孕期超声检查次数更少。选择性剖宫产和急诊剖宫产的频率在文化适应程度方面无显著差异。对文化适应程度与产科参数之间可能关系进行逻辑回归分析的结果显示，在早产、5分钟阿氏评分>7、脐动脉pH值>7.00以及新生儿入住新生儿病房方面无显著差异。
在柏林，移民妇女中文化适应程度低可能对孕期护理服务的利用产生不利影响。然而，在柏林移民人群中，产科结局参数在文化适应程度方面并无相关差异。
