Leppälä Satu, Lamminpää Reeta, Gissler Mika, Vehviläinen-Julkunen Katri
Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, Kuopio 70211, Finland.
Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland.
J Migr Health. 2022 May 31;6:100122. doi: 10.1016/j.jmh.2022.100122. eCollection 2022.
The 2015 refugee crisis led into a forced migration of millions of people globally. As a consequence, many countries experienced a quick change in the proportion of conflict-area born migrants. This group being stated as an especially vulnerable group for suboptimal maternal health, a timely inspection of preventive maternity care was required. This study investigated prenatal care in terms of gestation trimester at the first prenatal visit, number of check-ups prior to birth, and prepartum hospitalization in conflict-country born migrants and Finnish parturients in Finland.
Cross-sectional study included all pregnancies of migrants born in conflict-affected countries ( = 3 155) and country-born parturients ( = 93 600) in Finland in 2015-16. The data were obtained through Medical Birth Registry and Population Information System. Statistical analysis employed T-test, Chi-square test, and logistic regression analysis. Odds ratios with 95% Confidence Intervals (CI) were adjusted for sociodemographic and health-related background variables.
Migrant parturients had a higher probability for delayed enter in prenatal care compared with Finnish-born parturients (adjusted odds ratio aOR = 3.46; 95% Confidence Interval CI 3.06, 3.91). Recommended minimum number of check-ups was participated by 95.3% of the migrant, and 96.4% of the Finnish-born group ( <0.000). Migrants' probability for more than ten visits prior to term birth was significantly lower (aOR = 0.58; 95% CI 0.51, 0.66). No significant differences in prepartum hospitalization yielded between the groups.
Migrant parturients had significantly smaller number of check-ups and later entry in care compared with the country-born parturients. These findings add to earlier reported challenges in the organizing of conflict-affected country born migrants' prenatal care in a high-income setting, in which the proportion of conflict-area born migrants has risen rapidly and unexpectedly.
2015年的难民危机导致全球数百万人被迫迁移。因此,许多国家冲突地区出生的移民比例迅速变化。这一群体被视为孕产妇健康状况欠佳的特别脆弱群体,因此需要及时检查预防性孕产保健情况。本研究调查了在芬兰出生于冲突国家的移民产妇和芬兰产妇在首次产前检查时的孕周、产前检查次数以及产前住院情况。
横断面研究纳入了2015 - 2016年在芬兰出生于受冲突影响国家的移民产妇(n = 3155)和本国出生的产妇(n = 93600)的所有妊娠情况。数据通过医疗出生登记处和人口信息系统获取。统计分析采用t检验、卡方检验和逻辑回归分析。对社会人口学和健康相关背景变量调整了95%置信区间(CI)的比值比。
与芬兰出生的产妇相比,移民产妇延迟进入产前保健的可能性更高(调整后的比值比aOR = 3.46;95%置信区间CI 3.06, 3.91)。95.3%的移民产妇和96.4%的芬兰出生组产妇进行了建议的最少检查次数(P<0.000)。移民产妇在足月前进行十次以上检查的可能性显著更低(aOR = 0.58;95% CI 0.51, 0.66)。两组之间在产前住院方面没有显著差异。
与本国出生的产妇相比,移民产妇的检查次数显著更少且进入保健的时间更晚。这些发现进一步证明了此前报道的在高收入环境中为难民危机影响国家出生的移民组织产前保健方面的挑战,在这种环境中,冲突地区出生的移民比例迅速且意外地上升。