Gudmundsdottir Embla Yr, Vigfusdottir Lilja, Gottfredsdottir Helga
Department of Midwifery, Faculty of Nursing and Midwifery, University of Iceland, Iceland, The Reykjavík Birth Center, Iceland.
The Health Directorate of East Iceland, Iceland.
Laeknabladid. 2023 Feb;109(2):75-81. doi: 10.17992/lbl.2023.02.729.
Migrant women often experience worse perinatal outcomes during pregnancy, birth, and puerperium than native women, but results regarding preterm birth vary. The objective of this study was to detect the prevalence and risk factors of preterm birth among Icelandic and migrant women in Iceland.
The study was a population-based cohort study with data from the Icelandic Medical Birth Register. The cohort included all women who had a singleton birth from 22w0d to 36w6d of pregnancy in the years 1997-2018, a total of 89 170 women. The group was divided in two; women with an Icelandic citizenship and women with foreign citizenship, that were further divided according to the Human Development Index (HDI) of their country of citizenship. Preterm birth rate and risk factor prevalence was analysed according to this classification and significance in differences measured with a chi-square test.
Significance in differences of preterm birth was found between Icelandic (4.4%) and migrant women (5.6%) (p<0.001). Migrant women from middle-HDI countries gave birth preterm in 5.5% of cases (p<0.01) and women from low-HDI countries in 6.4% of cases (p<0.001). Migrant women were more often diagnosed with urinary tract infections, diabetes, intrauterine growth restriction and premature rupture of membranes, but less often with pre-eclampsia, obesity, placental defect, mental health issues and age p<18 years (p<0.05).
Migrant women in Iceland from middle-HDI and low-HDI countries give birth preterm more often than Icelandic women. A difference in risk factors is also present and needs further research. The findings can be used in continuing development of prenatal care for migrant women in Iceland.
与本地女性相比,移民女性在孕期、分娩期及产褥期往往经历更差的围产期结局,但关于早产的结果存在差异。本研究的目的是检测冰岛本土女性和移民女性中早产的患病率及危险因素。
本研究是一项基于人群的队列研究,数据来自冰岛医疗出生登记处。该队列包括1997年至2018年期间所有孕周为22周0天至36周6天的单胎分娩女性,共计89170名女性。该组分为两组;冰岛公民女性和外国公民女性,后者再根据其国籍所在国家的人类发展指数(HDI)进一步划分。根据此分类分析早产率和危险因素患病率,并通过卡方检验测量差异的显著性。
冰岛女性(4.4%)和移民女性(5.6%)的早产差异具有显著性(p<0.001)。来自中等HDI国家的移民女性早产率为5.5%(p<0.01),来自低HDI国家的女性早产率为6.4%(p<0.001)。移民女性更常被诊断出患有尿路感染、糖尿病、胎儿生长受限和胎膜早破,但患先兆子痫、肥胖、胎盘缺陷、心理健康问题及年龄小于18岁的情况较少(p<0.05)。
冰岛中HDI和低HDI国家的移民女性早产率高于冰岛女性。危险因素也存在差异,需要进一步研究。这些发现可用于冰岛移民女性产前护理的持续发展。