The University of Auckland Faculty of Medical and Health Sciences, Obstetrics & Gynaecology, Auckland, New Zealand.
Te Toka Tumai Auckland, Te Whatu Ora Health, Auckland, New Zealand.
Aust N Z J Obstet Gynaecol. 2023 Aug;63(4):499-508. doi: 10.1111/ajo.13626. Epub 2022 Oct 25.
The New Zealand (NZ) Ministry of Health ethnicity data protocols recommend that people of South Asian (SAsian) ethnicity, other than Indian, are combined with people of Japanese and Korean ethnicity at the most commonly used level of aggregation in health research (level two). This may not work well for perinatal studies, as it has long been observed that women of Indian ethnicity have higher rates of adverse pregnancy outcomes, such as perinatal death. It is possible that women of other SAsian ethnicities share this risk.
This study was performed to identify appropriate groupings of women of SAsian ethnicity for perinatal research.
National maternity and neonatal data, and singleton birth records between 2008 and 2017 were linked using the Statistics NZ Integrated Data Infrastructure. Socio-demographic risk profiles and pregnancy outcomes were compared between 15 ethnic groups. Recommendations were made based on statistical analyses and cultural evaluation with members of the SAsian research community.
Similarities were observed between women of Indian, Fijian Indian, South African Indian, Sri Lankan, Bangladeshi and Pakistani ethnicities. A lower-risk profile was seen among Japanese and Korean mothers. Risk profiles of women of combined Indian-Māori, Indian-Pacific and Indian-New Zealand European ethnicity more closely represented their corresponding non-Indian ethnicities.
Based on these findings, we suggest a review of current NZ Ministry of Health ethnicity data protocols. We recommend that researchers understand the risk profiles of participants prior to aggregation of groups in research, to mitigate risks associated with masking differences.
新西兰(NZ)卫生部的种族数据协议建议,南亚(SAsian)族裔中的非印度人,与日裔和韩裔一起,在健康研究中最常用的聚合级别(二级)进行组合。这对于围产期研究可能效果不佳,因为长期以来一直观察到印度族裔的女性不良妊娠结局(如围产儿死亡)的发生率更高。其他南亚族裔的女性可能也存在这种风险。
本研究旨在确定南亚族裔女性的适当分组,以进行围产期研究。
利用新西兰统计局综合数据基础设施,将 2008 年至 2017 年期间的全国产妇和新生儿数据以及单胎出生记录进行了链接。比较了 15 个种族群体的社会人口学风险概况和妊娠结局。根据统计分析和与南亚研究社区成员的文化评估提出了建议。
观察到印度、斐济印度、南非印度、斯里兰卡、孟加拉国和巴基斯坦族裔女性之间存在相似之处。日裔和韩裔母亲的风险状况较低。印度-毛利、印度-太平洋和印度-新西兰欧洲族裔的混血母亲的风险状况更接近其相应的非印度族裔。
基于这些发现,我们建议审查当前新西兰卫生部的种族数据协议。我们建议研究人员在研究中对群体进行分组之前,了解参与者的风险概况,以减轻与掩盖差异相关的风险。