Boxall Nicole, David Matthias, Schalinski Elisabeth, Breckenkamp Jürgen, Razum Oliver, Hellmeyer Lars
Charité - Universitätsmedizin Berlin, Klinik für Gynäkologie, Campus Virchow-Klinikum, Berlin, Germany.
Vivantes Klinikum im Friedrichshain, Klinik für Gynäkologie und Geburtsmedizin, Berlin, Germany.
Geburtshilfe Frauenheilkd. 2018 Jul;78(7):697-706. doi: 10.1055/a-0636-4224. Epub 2018 Jul 25.
Perinatal data of women with a Vietnamese migration background have not been systematically studied in Germany to date. Numerous details of important maternal and child outcomes were compared and analysed. The study's primary parameters were the frequency of and indication for c-section.
The perinatal data from a Berlin hospital were analysed retrospectively. The women (Vietnamese migration background vs. autochthonous) were grouped using name analysis. Datasets of 3002 women giving birth, including 999 women with a Vietnamese migration background, were included. The associations between primary or secondary cesarean delivery and different child outcomes depending on the migration background (exposure) were studied using logistical regression analysis.
Women with a Vietnamese migration background have a lower c-section rate of 8.0% for primary and 12.6% for secondary c-section than women without a migration background (11.1% primary and 16.4% secondary c-section respectively). Regression analysis shows that the odds that women with a Vietnamese migration background will have a primary (OR 0.75; p = 0.0884) or secondary c-section (OR 0.82; p = 0.1137) are not significantly lower. A Vietnamese migration background was associated with higher odds for an episiotomy but not for a grade 3 - 4 perineal tear. A Vietnamese migration background does not have a significant influence on poor 5-min Apgar scores ≤ 7 and low umbilical cord arterial pH values ≤ 7.10. Newborns of mothers with a Vietnamese migration background have higher odds of a relatively higher birth weight (> 3110 g).
There was no evidence that women with a Vietnamese migration background are delivered more often by caesarean section. There were also no differences as regards important child outcome data from women in the comparator group. Overall, the results do not provide any evidence for poorer quality of care of women with a Vietnamese migration background in Berlin despite the cultural and communication barriers in the reality of care provision.
迄今为止,德国尚未对有越南移民背景的女性的围产期数据进行系统研究。对重要母婴结局的众多细节进行了比较和分析。该研究的主要参数是剖宫产的频率和指征。
对柏林一家医院的围产期数据进行回顾性分析。通过名字分析对女性(越南移民背景与本地女性)进行分组。纳入了3002名分娩女性的数据集,其中包括999名有越南移民背景的女性。使用逻辑回归分析研究了根据移民背景(暴露因素)的初次或二次剖宫产与不同儿童结局之间的关联。
有越南移民背景的女性初次剖宫产率为8.0%,二次剖宫产率为12.6%,低于无移民背景的女性(分别为11.1%和16.4%)。回归分析表明,有越南移民背景的女性进行初次剖宫产(比值比0.75;p = 0.0884)或二次剖宫产(比值比0.82;p = 0.1137)的几率并没有显著降低。越南移民背景与更高的会阴切开术几率相关,但与3 - 4度会阴撕裂几率无关。越南移民背景对5分钟阿氏评分≤7分和脐动脉pH值≤7.10的不良情况没有显著影响。有越南移民背景的母亲所生新生儿出生体重相对较高(> 3110克)的几率更高。
没有证据表明有越南移民背景的女性剖宫产率更高。在比较组中,重要儿童结局数据方面也没有差异。总体而言,尽管在实际护理中存在文化和沟通障碍,但结果并未提供任何证据表明柏林有越南移民背景的女性护理质量较差。