Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, 75014 Paris, France.
Department of Obstetrics and Gynaecology, Robert Debré Hospital, AP-HP, Université de Paris, 75019 Paris, France.
Int J Environ Res Public Health. 2020 Sep 30;17(19):7174. doi: 10.3390/ijerph17197174.
Barriers to access to prenatal care may partially explain the higher risk of adverse pregnancy outcomes among migrants compared with native-born women in Europe. Our aim was to assess the association between women's legal status and inadequate prenatal care utilization (PCU) in France, where access to healthcare is supposed to be universal. The study population was extracted from the PreCARE prospective cohort (N = 10,419). The associations between women's legal status and a composite outcome variable of inadequate PCU were assessed with multivariate logistic regressions. The proportion of women born in sub-Saharan Africa (SSA) was higher among the undocumented than that of other migrants. All groups of migrant women had a higher risk of inadequate PCU (31.6% for legal migrants with European nationalities, 40.3% for other legal migrants, and 52.0% for undocumented migrants) than French-born women (26.4%). The adjusted odds ratio (aOR) for inadequate PCU for undocumented migrants compared with that for French-born women was 2.58 (95% confidence interval 2.16-3.07) overall, and this association was similar for migrant women born in SSA (aOR 2.95, 2.28-3.82) and those born elsewhere (aOR 2.37, 1.89-2.97). Regardless of the maternal place of birth, undocumented migrant status is associated with a higher risk of inadequate PCU.
获得产前保健的障碍可能部分解释了与欧洲本土出生的女性相比，移民的不良妊娠结局风险更高。我们的目的是评估法国妇女的法律地位与产前保健利用不足（PCU）之间的关联，因为在法国，获得医疗保健被认为是普遍的。研究人群从 PreCARE 前瞻性队列中提取（N=10419）。使用多变量逻辑回归评估妇女法律地位与产前保健利用不足的综合结果变量之间的关联。与其他移民相比，无证移民中来自撒哈拉以南非洲（SSA）的女性比例较高。所有移民群体的产前保健利用不足的风险都高于法国出生的女性（具有欧洲国籍的合法移民为 31.6%，其他合法移民为 40.3%，无证移民为 52.0%）。与法国出生的女性相比，无证移民的产前保健利用不足的调整后比值比（aOR）为 2.58（95%置信区间为 2.16-3.07），对于出生在 SSA 的移民女性（aOR 2.95，2.28-3.82）和出生在其他地方的移民女性（aOR 2.37，1.89-2.97），这种关联相似。无论产妇的出生地如何，无证移民身份与产前保健利用不足的风险增加相关。
