Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands.
Amsterdam Public Health, Mental Health Program, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
Matern Child Health J. 2022 Aug;26(8):1613-1621. doi: 10.1007/s10995-022-03451-0. Epub 2022 Jun 2.
Previous studies reported less prenatal healthcare consumption and more perinatal complications in women with a migrant background. Hence, we investigated in a country with free healthcare access whether women with a migrant background differed with respect to pregnancy complications, healthcare consumption and in terms of associations with psychological distress in comparison to native Dutch.
We included 324 native Dutch and 303 women with a migrant background, who visited two hospitals in Amsterdam for antenatal care between 2014 and 2015. Participants completed the Edinburgh Postnatal Depression Scale, the Hospital Depression and Anxiety Scale, and sociodemographic questions. Complications and healthcare consumption during pregnancy were extracted from medical records. Regression analyses were used with adjustment for covariates.
Except for gestational diabetes [adjusted OR = 3.09; 95% CI = (1.51, 6.32)], no differences were found between groups in perinatal complications [OR = 1.15; 95% CI = (0.80, 1.64)], nor in healthcare consumption [OR = 0.87; 95% CI = (0.63, 1.19)]. Women with a migrant background reported more depressive symptoms [Cohen's d = 0.25; 95% CI = (0.10, 0.41)], even after adjustment for socio-economic factors. Psychological distress was associated with more hospital admissions during pregnancy. When experiencing depressive symptoms, women with a migrant background had an increased risk to be admitted [OR = 1.11; 95% CI = (1.01, 1.21)].
This cohort study found no differences in pregnancy-related complications, except for diabetes, nor different healthcare consumption, in women with a migrant background versus native Dutch, in a country with free health care access. However, women with a migrant background experienced more depressive symptoms, and when depressed their risk for hospital admission increased. Additional research is warranted to improve healthcare for this population.
先前的研究报告称，具有移民背景的女性产前保健消费较少，围产期并发症较多。因此，我们在一个享有免费医疗保健的国家调查了具有移民背景的女性在妊娠并发症、医疗保健消费方面是否存在差异，并与荷兰本地女性进行了比较，以及这些差异与心理困扰的关系。
我们纳入了 2014 年至 2015 年期间在阿姆斯特丹的两家医院接受产前护理的 324 名荷兰本地女性和 303 名具有移民背景的女性。参与者完成了爱丁堡产后抑郁量表、医院抑郁和焦虑量表以及社会人口学问题的调查。从医疗记录中提取了妊娠期间的并发症和医疗保健消费数据。使用回归分析进行了调整协变量的分析。
除了妊娠期糖尿病（调整后的 OR=3.09；95%CI=（1.51，6.32）），两组在围产期并发症方面（OR=1.15；95%CI=（0.80，1.64））或医疗保健消费方面（OR=0.87；95%CI=（0.63，1.19））没有差异。具有移民背景的女性报告了更多的抑郁症状（Cohen's d=0.25；95%CI=（0.10，0.41）），即使在调整了社会经济因素后也是如此。心理困扰与怀孕期间更多的住院治疗有关。当出现抑郁症状时，具有移民背景的女性住院的风险增加（OR=1.11；95%CI=（1.01，1.21））。
这项队列研究发现，在享有免费医疗保健的国家中，与荷兰本地女性相比，具有移民背景的女性在妊娠相关并发症方面（除了糖尿病）没有差异，医疗保健消费也没有差异。然而，具有移民背景的女性经历了更多的抑郁症状，当她们感到抑郁时，住院的风险增加。需要进一步的研究来改善对这一人群的医疗保健。
