Mohabier Kajal S C, de Graaf Hanneke P, Steegers Eric A P, Bertens Loes C M
Department of Obstetrics and Gynaecology, Erasmus University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands.
BMC Pregnancy Childbirth. 2025 Apr 11;25(1):429. doi: 10.1186/s12884-025-07401-w.
Socioeconomic disadvantaged circumstances are known to affect health outcomes, but during pregnancy it also affects the growth and development of the fetus. This often results in adverse perinatal outcomes and other long lasting effects. Here we refer to pregnant women living in such circumstances as a highly vulnerable population.
To study adverse perinatal outcomes in highly vulnerable pregnant women within the Mothers of Rotterdam (MoR) study and to compare findings to the outcomes of women in the Netherlands as a whole and the city of Rotterdam.
Pregnancy and childbirth data from women participating in the MoR study (2015-2019) was requested from their obstetric professional. For comparison, data from the Dutch national birth registry (Perined) were used representing women in the Netherlands and Rotterdam. Main outcome measures were preterm birth (PTB) and small for gestational age (SGA). Secondary outcome measures were perinatal mortality and a low Apgar score. Only singleton viable pregnancies (i.e. birthweight above 500 g or born after 22 + 0 weeks of gestation) were included in this study. Prevalence rates and corresponding 95% confidence intervals (95%CI) were calculated for all outcomes in each group. Direct standardization was used to account for possible differences in case-mix composition between the studied groups.
Data on 346 childbirths within the MoR study were retrieved and compared to 813,755 and 34,009 childbirths in the Netherlands and Rotterdam, respectively. The prevalence of PTB (4.34% (95%CI 2.19-6.48) was lower in the MoR population compared to both the Netherlands (6.21% (95%CI 6.16-6.27)) and Rotterdam (6.39% (95%CI 6.13-6.65)). The prevalence of SGA (21.09% (95% CI 16.80-25.40)) was higher in the MoR population compared to both the Netherlands (10.11% (95%CI 10.04-10.17)) and Rotterdam (13.28% (95%CI 12.92-13.65)). There were no cases of perinatal mortality registered in the MoR population. The prevalence of a low Apgar score (0.87% (95%CI 0.00-1.84)) was lower in the MoR population.
Our study found unexpected low PTB and high SGA prevalence rates in the MoR population compared to the Netherlands and Rotterdam. Mechanisms through which socioeconomic disadvantaged circumstances affect perinatal health seem to work differently in various strata of vulnerable populations.
已知社会经济不利环境会影响健康结果，而在孕期，它还会影响胎儿的生长发育。这往往会导致不良围产期结局及其他长期影响。在此，我们将生活在这种环境中的孕妇视为高度脆弱人群。
在鹿特丹母亲（MoR）研究中，研究高度脆弱孕妇的不良围产期结局，并将研究结果与荷兰整体女性以及鹿特丹市女性的结局进行比较。
向参与MoR研究（2015 - 2019年）的女性的产科专业人员索取其妊娠和分娩数据。为作比较，使用了荷兰国家出生登记处（Perined）的数据，这些数据代表了荷兰和鹿特丹的女性。主要结局指标为早产（PTB）和小于胎龄儿（SGA）。次要结局指标为围产期死亡率和低Apgar评分。本研究仅纳入单胎存活妊娠（即出生体重超过500克或妊娠22 + 0周后出生）。计算每组所有结局的患病率及相应的95%置信区间（95%CI）。采用直接标准化来考虑研究组间病例组合构成可能存在的差异。
检索到MoR研究中346例分娩的数据，并分别与荷兰的813,755例和鹿特丹的34,009例分娩数据进行比较。与荷兰（6.21%（95%CI 6.16 - 6.27））和鹿特丹（6.39%（95%CI 6.13 - 6.65））相比，MoR人群中早产的患病率（4.34%（95%CI 2.19 - 6.48））较低。与荷兰（10.11%（95%CI 10.04 - 10.17））和鹿特丹（13.28%（95%CI 12.92 - 13.65））相比，MoR人群中小于胎龄儿的患病率（21.09%（95%CI 16.80 - 25.40））较高。MoR人群中未登记到围产期死亡病例。MoR人群中低Apgar评分的患病率（0.87%（95%CI 0.00 - 1.84））较低。
我们的研究发现，与荷兰和鹿特丹相比，MoR人群中早产患病率意外较低，而小于胎龄儿患病率较高。社会经济不利环境影响围产期健康的机制在不同脆弱人群阶层中似乎发挥方式不同。
