Balcazar H, Hartner J, Cole G
Department of Family Resources and Human Development, Arizona State University, Tempe 85287-2502.
J Natl Med Assoc. 1993 Mar;85(3):195-202.
This study evaluates the effects of prenatal care classification and levels of maternal risk status on pregnancy outcomes in Mexican Americans and non-Hispanic whites in Arizona. All live birth certificates from 1986 and 1987 were reviewed yielding a total population of 101,206 (26,827 Mexican Americans). The adequacy of prenatal care was evaluated based on an index that includes six prenatal care groups. Two levels of maternal risk status (low and high) were defined based on a series of maternal risk factors. Overall, Mexican Americans had a greater proportion of maternal risk factors and a greater proportion of mothers with inadequate or no prenatal care compared with non-Hispanic whites. Prematurity and macrosomia were more prevalent than low birthweight in Mexican Americans. Low-risk status and adequate prenatal care regardless of ethnicity were found to be associated with a lower prevalence of low birthweight and preterm delivery. Whites, however, had a greater variation in the prevalence of low birthweight associated with changes in prenatal care utilization and maternal risk status compared with Mexican Americans. Finally, logistic regression analysis showed an independent effect of prenatal care, maternal risk status, maternal age, and maternal birthplace in predicting the overall low birthweight rate in Mexican Americans. The implications of these results are discussed relative to the usefulness of prenatal care as a health-care intervention in Mexican Americans.
本研究评估了产前护理分类和孕产妇风险状况水平对亚利桑那州墨西哥裔美国人及非西班牙裔白人妊娠结局的影响。对1986年和1987年所有的出生证明进行了审查，共涉及101,206人（其中26,827名墨西哥裔美国人）。基于一个包含六个产前护理组别的指数来评估产前护理的充分性。根据一系列孕产妇风险因素定义了两个孕产妇风险状况级别（低和高）。总体而言，与非西班牙裔白人相比，墨西哥裔美国人中孕产妇风险因素的比例更高，产前护理不足或未接受产前护理的母亲比例也更高。墨西哥裔美国人中早产和巨大儿比低出生体重更为普遍。无论种族如何，低风险状况和充分的产前护理都与较低的低出生体重和早产患病率相关。然而，与墨西哥裔美国人相比，白人中低出生体重患病率随产前护理利用情况和孕产妇风险状况变化的差异更大。最后，逻辑回归分析表明，产前护理、孕产妇风险状况、孕产妇年龄和孕产妇出生地对预测墨西哥裔美国人总体低出生体重率具有独立影响。相对于产前护理作为墨西哥裔美国人医疗保健干预措施的有用性，讨论了这些结果的意义。
