文化适应对居住在西澳大利亚的移民妇女早产和低出生体重风险的影响。
The influence of acculturation on the risk of preterm birth and low birthweight in migrant women residing in Western Australia.
机构信息
Discipline of Obstetrics and Gynaecology, Medical School, The University of Western Australia, Perth, WA, Australia.
School of Population and Global Health, The University of Western Australia, Perth, WA, Australia.
出版信息
PLoS One. 2023 May 10;18(5):e0285568. doi: 10.1371/journal.pone.0285568. eCollection 2023.
BACKGROUND
The risk of preterm birth (PTB) and low birthweight (LBW) may change over time the longer that immigrants reside in their adopted countries. We aimed to study the influence of acculturation on the risk of these outcomes in Australia.
METHODS
A retrospective cohort study using linked health data for all non-Indigenous births from 2005-2013 in Western Australia was undertaken. Acculturation was assessed through age on arrival, length of residence, interpreter use and having an Australian-born partner. Adjusted odds ratios (aOR) for term-LBW and PTB (all, spontaneous, medically-indicated) were calculated using multivariable logistic regression in migrants from six ethnicities (white, Asian, Indian, African, Māori, and 'other') for different levels of acculturation, compared to the Australian-born population as the reference.
RESULTS
The least acculturated migrant women, those from non-white non-Māori ethnic backgrounds who immigrated at age ≥18 years, had an overseas-born partner, lived in Australia for < 5 years and used a paid interpreter, had 58% (aOR 1.58, 95% CI 1.15-2.18) higher the risk of term-LBW and 40% (aOR 0.60, 95% CI 0.45-0.80) lower risk of spontaneous PTB compared to the Australian-born women. The most acculturated migrant women, those from non-white non-Māori ethnic backgrounds who immigrated at age <18 years, had an Australian-born partner, lived in Australia for > 10 years and did not use an interpreter, had similar risk of term-LBW but 43% (aOR 1.43, 95% CI 1.14-1.78) higher risk of spontaneous PTB than the Australian-born women.
CONCLUSION
Acculturation is an important factor to consider when providing antenatal care to prevent PTB and LBW in migrants. Acculturation may reduce the risk of term-LBW but, conversely, may increase the risk of spontaneous PTB in migrant women residing in Western Australia. However, the effect may vary by ethnicity and warrants further investigation to fully understand the processes involved.
背景
随着移民在其移居国居住时间的延长，早产（PTB）和低出生体重（LBW）的风险可能会发生变化。我们旨在研究文化适应对澳大利亚这些结局风险的影响。
方法
我们进行了一项回顾性队列研究，使用 2005 年至 2013 年西澳大利亚所有非土著出生的相关健康数据。通过到达时的年龄、居住时间、使用口译员和有澳大利亚出生的伴侣来评估文化适应程度。在不同程度的文化适应程度下，来自六个族裔（白种人、亚洲人、印度人、非洲人、毛利人和“其他”）的移民与澳大利亚出生的人群相比，计算了足月低出生体重儿和早产（所有、自发性、医学上指的）的调整优势比（aOR）。
结果
最不适应文化的移民女性，即那些年龄≥18 岁、来自非白人和非毛利族裔背景、有海外出生的伴侣、在澳大利亚居住时间<5 年、使用付费口译员的女性，足月低出生体重儿的风险增加了 58%（aOR 1.58，95%CI 1.15-2.18），自发性早产的风险降低了 40%（aOR 0.60，95%CI 0.45-0.80），与澳大利亚出生的女性相比。最适应文化的移民女性，即那些年龄<18 岁、来自非白人和非毛利族裔背景、有澳大利亚出生的伴侣、在澳大利亚居住时间>10 年且不使用口译员的女性，足月低出生体重儿的风险相似，但自发性早产的风险增加了 43%（aOR 1.43，95%CI 1.14-1.78），与澳大利亚出生的女性相比。
结论
在为移民提供产前保健以预防早产和低出生体重儿时，文化适应是一个需要考虑的重要因素。文化适应可能会降低足月低出生体重儿的风险，但相反，可能会增加居住在西澳大利亚的移民妇女自发性早产的风险。然而，这种影响可能因族裔而异，需要进一步研究以充分了解所涉及的过程。
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