Swiss Tropical and Public Health Institute, Basel, Switzerland.
University of Basel, Basel, Switzerland.
Int J Public Health. 2024 May 8;69:1606745. doi: 10.3389/ijph.2024.1606745. eCollection 2024.
This study aims to compare obstetric outcomes between Eritrean and Swiss women in Switzerland, focusing on instrumental or surgical interventions and analgesia use. The study included data from 45,412 Swiss and 1,132 Eritrean women who gave birth in Swiss hospitals (2019-2022). Mixed-effects logistic regression was used to assess the effect of nationality on mode of delivery and analgesia use and multinomial mixed-effects logistic regression to assess the effect of nationality on mode of delivery in women intended for spontaneous vaginal delivery. Compared with Swiss, Eritrean women had a lower rate of primary C-section (Adj. OR 0.73, 95% CI [0.60, 0.89]) but a higher risk of initially planned vaginal deliveries ending in emergency C-section (RRR 1.31, 95% CI [1.05, 1.63]). Eritrean women were less likely to receive epidural analgesia (Adj. OR 0.53, 95% CI [0.45, 0.62]) and more likely to not receive any analgesia (Adj. OR 1.73, 95% CI [1.52, 1.96]). This study reveals disparities in obstetric care, notably in higher emergency C-section rates and lower analgesia use among Eritrean women. For promoting equitable healthcare practices deeper understanding of obstetrics decision-making is needed.
本研究旨在比较瑞士的厄立特里亚和瑞士妇女的产科结局,重点关注器械或手术干预以及镇痛药物的使用。该研究纳入了 2019 年至 2022 年间在瑞士医院分娩的 45412 名瑞士妇女和 1132 名厄立特里亚妇女的数据。采用混合效应逻辑回归评估国籍对分娩方式和镇痛药物使用的影响,采用多项混合效应逻辑回归评估国籍对计划自然分娩妇女分娩方式的影响。与瑞士妇女相比,厄立特里亚妇女初次剖宫产率较低(调整后的比值比 [Adj. OR] 0.73,95%置信区间 [0.60,0.89]),但最初计划的阴道分娩转为紧急剖宫产的风险较高(相对风险增加 [RRR] 1.31,95%置信区间 [1.05,1.63])。厄立特里亚妇女接受硬膜外镇痛的可能性较小(调整后的比值比 [Adj. OR] 0.53,95%置信区间 [0.45,0.62]),而不接受任何镇痛的可能性较大(调整后的比值比 [Adj. OR] 1.73,95%置信区间 [1.52,1.96])。本研究揭示了产科护理方面的差异,特别是厄立特里亚妇女的紧急剖宫产率较高和镇痛药物使用率较低。为了促进公平的医疗保健实践,需要更深入地了解产科决策。