社会经济地位和移民身份对急诊剖宫产的预测作用：一项出生队列研究。
Socioeconomic and migration status as predictors of emergency caesarean section: a birth cohort study.
机构信息
Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany.
Centre for Statistics (ZeSt), Bielefeld University, Bielefeld, Germany.
出版信息
BMC Pregnancy Childbirth. 2020 Jan 13;20(1):32. doi: 10.1186/s12884-020-2725-5.
BACKGROUND
Women with a migration background are reportedly at a higher risk of emergency caesarean section. There is evidence that this is due in part to suboptimal antenatal care use and quality of care. Despite the fact that migrant women and descendants of migrants are often at risk of socioeconomic disadvantage, there is, in comparison, scarce and incomplete evidence on the role of socioeconomic position as an independent risk factor for emergency caesarean delivery. We therefore investigate whether and how migration background and two markers of socioeconomic position affect the risk of an emergency caesarean section and whether they interact with each other.
METHODS
In 2013-2016, we recruited women during the perinatal period in Bielefeld, Germany, collecting data on health and socioeconomic and migration background, as well as routine perinatal data. We studied associations between migration background (1st generation migrant, 2nd/3rd generation woman, no migration background), socioeconomic status (educational attainment and net monthly household income), and the outcome emergency caesarean section.
RESULTS
Of the 881 participants, 21% (n = 185) had an emergency caesarean section. Analyses showed no association between having an emergency caesarean section and migration status or education. Women in the lowest (< 800€/month) and second lowest (between 800 and 1750€/month) income categories were more likely (aOR: 1.96, CI: 1.01-3.81; and aOR: 2.36, CI: 1.27-4.40, respectively) to undergo an emergency caesarean section than women in the higher income groups.
CONCLUSIONS
Migration status and education did not explain heterogeneity in mode of birth. Having a low household income, however, increased the chances of emergency caesarean section and thereby contributed towards producing health disadvantages. Awareness of these findings and measures to correct these inequalities could help to improve the quality of obstetric care.
背景
据报道，有移民背景的女性行急诊剖宫产的风险更高。有证据表明，这部分是由于产前护理的利用和护理质量不理想。尽管移徙妇女及其移民后代往往面临社会经济劣势的风险，但相比之下，关于社会经济地位作为急诊剖宫产独立风险因素的作用的证据很少且不完整。因此，我们调查了移民背景和两个社会经济地位指标是否以及如何影响急诊剖宫产的风险，以及它们是否相互作用。
方法
2013-2016 年，我们在德国比勒费尔德招募了围产期妇女，收集了健康和社会经济及移民背景以及常规围产期数据。我们研究了移民背景（第一代移民、第二代/第三代妇女、无移民背景）、社会经济地位（教育程度和净月家庭收入）与结局急诊剖宫产之间的关系。
结果
在 881 名参与者中，21%（n=185）行急诊剖宫产。分析显示，行急诊剖宫产与移民身份或教育程度无关。收入最低（<800 欧元/月）和第二低（800 至 1750 欧元/月）类别的女性更有可能（aOR：1.96，CI：1.01-3.81；和 aOR：2.36，CI：1.27-4.40）行急诊剖宫产，而收入较高类别的女性。
结论
移民身份和教育程度不能解释分娩方式的异质性。然而，家庭收入低会增加急诊剖宫产的机会，从而导致健康劣势。了解这些发现并采取措施纠正这些不平等现象，有助于提高产科护理质量。
Zotero 插件