Alexy B, Nichols B, Heverly M A, Garzon L
School of Nursing, Old Dominion University, Norfolk, VA 23529, USA.
Res Nurs Health. 1997 Feb;20(1):61-70. doi: 10.1002/(sici)1098-240x(199702)20:1<61::aid-nur7>3.0.co;2-s.
To determine whether predictors of birth outcomes differ for women in rural versus urban areas, data were obtained from the health records of women who received prenatal care through the Public Health Departments of a rural (N = 364) and urban (N = 415) setting. The rural group was more apt to be single, less educated, African-American, and have a lower income than the urban group. Rural women also had a higher incidence of low birth weight infants, which may be related to poor nutrition and low weight gain during pregnancy. Urban women had more maternal and neonatal complications, which may be related to a higher incidence of drug use and smoking. Membership in a rural or urban population did not predict low birth weight. Race, weeks gestation at first prenatal visit, number of total visits, and adequacy of diet and weight gain were significant predictors of birth weight. Neonatal complications were higher in the urban group and best predicted by poor diet, alcohol intake, and race. Both rural and urban women received inadequate prenatal care, as indicated by late entry into care and total number of visits. Alternative models of care which explore strategies to individualize care, while providing comprehensive care, should be investigated.
为了确定农村和城市地区女性的分娩结局预测因素是否存在差异，我们从通过农村（N = 364）和城市（N = 415）地区公共卫生部门接受产前护理的女性健康记录中获取了数据。与城市组相比，农村组女性更有可能单身、受教育程度较低、为非裔美国人且收入较低。农村女性低体重儿的发生率也更高，这可能与孕期营养不良和体重增加不足有关。城市女性有更多的孕产妇和新生儿并发症，这可能与药物使用和吸烟的较高发生率有关。农村或城市人口身份并不能预测低体重儿。种族、首次产前检查时的孕周、总就诊次数以及饮食和体重增加是否充足是出生体重的重要预测因素。城市组的新生儿并发症更高，不良饮食、酒精摄入和种族是其最佳预测因素。农村和城市女性都接受了不充分的产前护理，这体现在护理开始较晚和就诊总次数上。应该研究探索个性化护理策略同时提供全面护理的替代护理模式。
