Ethnic differences in antenatal care use in a large multi-ethnic urban population in the Netherlands
Ethnic differences in antenatal care use in a large multi-ethnic urban population in the Netherlands
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DOI：
10.1016/j.midw.2009.07.008
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发表时间：
2011-02-01
期刊：
影响因子：
2.7
通讯作者：
Foets, Marleen
中科院分区：
文献类型：
--
作者：
Chote, Anushka A.;de Groot, Christianne J. M.;Foets, Marleen
设计：R世代研究是一项基于多种族人群的前瞻性队列研究。背景：7名助产士参加在鹿特丹市进行的R世代研究。参与者：共有2093名具有荷兰、摩洛哥、土耳其、佛得角、安的列斯、苏里南-克里奥尔和苏里南-印度斯坦背景的孕妇纳入本研究。测量：为了评估充分的产前保健利用，我们构建了一个指数，包括两个指标；第一次就诊时的胎龄和产前检查的总次数。采用Logistic回归分析来评估不同种族和荷兰参照组之间充分使用产前护理的差异，同时考虑到产妇年龄、孕次和产次的差异。结果：总体而言，除了没有差异的荷兰妇女外，未足月分娩的妇女充分使用的百分比高于经产妇女。除了苏里南-印度斯坦人之外，所有少数民族妇女与荷兰土著妇女相比，充分使用的比例较低，特别是因为进入产前护理的时间较晚。在考虑到产妇年龄、怀孕和产次等潜在解释因素时，除佛得角妇女外，差异仍然很大。荷兰-安的列斯人、摩洛哥人和苏里南-克里奥尔人的妇女对产前护理的利用最不充分。主要结论：这项研究表明，在充分利用产前护理的频率上存在种族差异，这不能归因于母亲年龄、怀孕和产次的差异。未来有必要研究这些差异是否可以用社会经济和文化因素来解释。实践的意义：临床医生应该告诉初产妇女，特别是少数民族妇女，及时进入产前护理的重要性。(C)2009爱思唯尔有限公司。保留所有权利。
Objective: to determine differences in antenatal care use between the native population and different ethnic minority groups in the Netherlands.Design: the Generation R Study is a multi-ethnic population-based prospective cohort study.Setting: seven midwife practices participating in the Generation R Study conducted in the city of Rotterdam.Participants: in total 2093 pregnant women with a Dutch, Moroccan, Turkish, Cape Verdean, Antillean, Surinamese-Creole and Surinamese-Hindustani background were included in this study.Measurements: to assess adequate antenatal care use, we constructed an index, including two indicators; gestational age at first visit and total number of antenatal care visits.Logistic regression analysis was used to assess differences in adequate antenatal care use between different ethnic groups and a Dutch reference group, taking into account differences in maternal age, gravidity and parity.Findings: overall, the percentages of women making adequate use are higher in nulliparae than in multiparae, except in Dutch women where no differences are present.Except for the Surinamese-Hindustani, all women from ethnic minority groups make less adequate use as compared to the native Dutch women, especially because of late entry in antenatal care. When taking into account potential explanatory factors such as maternal age, gravidity and parity, differences remain significant, except for Cape-Verdian women. Dutch-Antillean, Moroccan and Surinamese-Creole women exhibit most inadequate use of antenatal care.Key conclusions: this study shows that there are ethnic differences in the frequency of adequate use of antenatal care, which cannot be attributed to differences in maternal age, gravidity and parity. Future research is necessary to investigate whether these differences can be explained by socio-economic and cultural factors.Implications for practise: clinicians should inform primiparous women, and especially those from ethnic minority groups, on the importance of timely antenatal care entry. (C) 2009 Elsevier Ltd. All rights reserved.