Timeliness, frequency and content of antenatal care: which is most important to reducing indigenous disparities in birth weight in Mexico?
Timeliness, frequency and content of antenatal care: which is most important to reducing indigenous disparities in birth weight in Mexico?
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DOI：
10.1093/heapol/czv082
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发表时间：
2016-05-01
影响因子：
3.2
通讯作者：
Darney, Blair G.
中科院分区：
文献类型：
--
作者：
Servan-Mori, Edson;Sosa-Rubi, Sandra G.;Darney, Blair G.
本文探讨了适当的产前保健（ANC）的组成部分在墨西哥土著和非土著妇女之间的出生体重差异的作用。我们估计，如果土著婴儿的母亲得到及时、频繁（>= 4次）和完整的产前护理（>= 75%的推荐护理过程），土著婴儿体重增加的可能性会增加。我们使用了基于人群的调查数据（2012年; N = 6612名12-49岁女性）。我们应用分位数回归来检查出生体重分布的分位数中足够的ANC、土著种族和出生体重之间的关联的异质性。与无法获得产前保健服务的妇女相比，报告出生体重不足婴儿的土著妇女比例更高（产前保健服务含量= 75%）：0.05和0.10两个分位数分别增加了180克和260克。这意味着最小的土著新生儿可能达到2.36公斤（从1.86公斤），接近正常体重阈值。ANC的频率与所有妇女的出生体重呈正相关，但完全ANC似乎对出生体重分布底部的土著妇女产生不同的影响。与未接受产前控制的土著/非土著新生儿相比，接受产前控制的土著新生儿获得的边际收益在低出生体重分位数中特别重要。因此，提供产前护理的基本过程可能会影响风险最高的妇女，并帮助她们克服低出生体重的门槛。
This article examines the role of components of adequate antenatal care (ANC) in disparities in birth weight between indigenous and non-indigenous women in Mexico. We estimate the potential for added weight gain among indigenous infants if their mothers received timely, frequent (>= 4 visits) and complete ANC (>= 75% of recommended processes of care). We used population-based survey data (2012; N = 6612 women 12-49). We applied quantile regression to examine heterogeneity of the association between adequate ANC, indigenous ethnicity and birth weight across quantiles of the birth weight distribution. A greater proportion of indigenous women reported a low-birth weight infant (= 75% of the content of ANC compared with those that did not have access: similar to 180 and 260 g are gained in both quantiles 0.05 and 0.10, respectively. This means that the smallest indigenous newborns could potentially reach 2.36 kg (from 1.86 kg), close to the normal weight threshold. The frequency of ANC was positively associated with birth weight for all women but complete ANC appears to differentially affect indigenous women at the bottom of the birth weight distribution. The marginal gains obtained among indigenous newborns that received complete ANC compared with indigenous/non-indigenous newborns did not receive it, is particularly important in low-birth weight quantiles. Delivering basic processes of ANC may therefore have the potential to impact the highest risk women and help them to overcome the low-birth weight threshold.