Explaining ethnic differences in late antenatal care entry by predisposing, enabling and need factors in The Netherlands. The Generation R Study.
Explaining ethnic differences in late antenatal care entry by predisposing, enabling and need factors in The Netherlands. The Generation R Study.
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DOI：
10.1007/s10995-010-0619-2
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发表时间：
2011-08
影响因子：
2.3
通讯作者：
Foets M
中科院分区：
文献类型：
--
作者：
Choté AA;Koopmans GT;Redekop WK;de Groot CJ;Hoefman RJ;Jaddoe VW;Hofman A;Steegers EA;Mackenbach JP;Trappenburg M;Foets M
尽管欧洲实行强制性医疗保险，但在获得医疗保健方面仍存在种族差异。本研究的目的是调查荷兰和非荷兰妇女之间的种族差异，就晚进入社区助产士提供的产前护理可以解释的需要，诱发和有利因素。数据来自Generation R研究。R世代研究是一项在鹿特丹市进行的基于多种族人群的前瞻性队列研究。总共有2，093名荷兰、摩洛哥、土耳其、佛得角、安的列斯、拉姆克里奥尔和拉姆印度斯坦背景的孕妇被纳入本研究。我们研究了是否可以通过需要、诱发和促成因素来解释晚期产前护理的种族差异。随后，逻辑回归分析被用来评估独立的作用，解释变量的产前保健进入的时间。主要的结局指标是进入产前护理的时间较晚（14周后首次就诊的胎龄）。除印度斯坦裔美籍妇女外，所有非荷兰籍母亲接受产前护理较晚的比例高于荷兰籍母亲。我们可以解释土耳其人（OR = 0.95，CI：0.57 - 1.58），佛得角人（OR = 1.65。CI：0.96 - 2.82）和荷兰女性。其他差异减小，但仍具有显著性（摩洛哥：OR = 1.74，CI：1.07 - 2.85;荷属安的列斯OR 1.80，CI：1.04 - 3.13）。我们发现，非荷兰籍母亲比荷兰籍母亲更有可能进入产前护理。由于我们无法充分解释摩洛哥、密克罗尼西亚-克里奥尔和安的列斯妇女之间的差异，今后的研究应侧重于第一代和第二代移民之间的差异，以及可能妨碍获得有关荷兰产科系统的充分信息的语言障碍。
Despite compulsory health insurance in Europe, ethnic differences in access to health care exist. The objective of this study is to investigate how ethnic differences between Dutch and non-Dutch women with respect to late entry into antenatal care provided by community midwifes can be explained by need, predisposing and enabling factors. Data were obtained from the Generation R Study. The Generation R Study is a multi-ethnic population-based prospective cohort study conducted in the city of Rotterdam. In total, 2,093 pregnant women with a Dutch, Moroccan, Turkish, Cape Verdean, Antillean, Surinamese Creole and Surinamese Hindustani background were included in this study. We examined whether ethnic differences in late antenatal care entry could be explained by need, predisposing and enabling factors. Subsequently, logistic regression analysis was used to assess the independent role of explanatory variables in the timing of antenatal care entry. The main outcome measure was late entry into antenatal care (gestational age at first visit after 14 weeks). With the exception of Surinamese-Hindustani women, the percentage of mothers entering antenatal care late was higher in all non-Dutch compared to Dutch mothers. We could explain differences between Turkish (OR = 0.95, CI: 0.57–1.58), Cape Verdean (OR = 1.65. CI: 0.96–2.82) and Dutch women. Other differences diminished but remained significant (Moroccan: OR = 1,74, CI: 1.07–2.85; Dutch Antillean OR 1.80, CI: 1.04–3.13). We found that non-Dutch mothers were more likely to enter antenatal care later than Dutch mothers. Because we are unable to explain fully the differences regarding Moroccan, Surinamese-Creole and Antillean women, future research should focus on differences between 1st and 2nd generation migrants, as well as on language barriers that may hinder access to adequate information about the Dutch obstetric system.
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影响因子：
13.6
作者：
Jaddoe, Vincent W. V.;Mackenbach, Johan P.;Hofman, Albert
通讯作者：
Hofman, Albert
影响因子：
7.2
作者：
Braveman, P;Marchi, K;Neuhaus, J
通讯作者：
Neuhaus, J
影响因子：
2.3
作者：
Frisbie, W P;Echevarria, S;Hummer, R A
通讯作者：
Hummer, R A
影响因子：
13.6
作者：
Jaddoe, Vincent W. V.;van Duijn, Cornelia M.;Hofman, Albert
通讯作者：
Hofman, Albert
影响因子：
2.7
作者：
Chote, Anushka A.;de Groot, Christianne J. M.;Foets, Marleen
通讯作者：
Foets, Marleen