Predictors of emergency cesarean delivery among international migrant women in Canada
Predictors of emergency cesarean delivery among international migrant women in Canada
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DOI：
10.1016/j.ijgo.2012.12.017
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发表时间：
2013-06-01
影响因子：
3.8
通讯作者：
Haase, Kristen
中科院分区：
文献类型：
--
作者：
Gagnon, Anita J.;Merry, Lisa;Haase, Kristen
目的：探讨外籍妇女急诊剖宫产的预测因素。方法：2006年2月至2009年5月，从多伦多、蒙特利尔和温哥华的12家医院招募了1025名产后移民妇女。Logistic回归模型的移民，社会，卫生服务和生物医学因素预测紧急剖宫产。结果：总体而言，14%的参与者接受了紧急剖宫产。最大的风险是第一次分娩的妇女（比值比[OR]，5.9; 95%置信区间[CI]，3.1-11.3）;新生儿体重≥ 4000 g（OR，3.5; 95% CI，1.9-6.5）;无健康保险（OR，2.8; 95% CI，12-6.4）;周五分娩（OR，2.2; 95%CI，1.2-3.9）;收入低于30 000加元（OR，1.9; 1.2-3.0）;引产（OR，1.8; 95%CI，1.1-3.0）。与移民相比，寻求庇护者（OR，0.3; 95%CI，0.2-0.6）和难民（OR，0.5; 95%CI，0.2 -1.0）免于紧急剖宫产。结论：具体的指标，或更常见的，移民在评估紧急剖宫产的可能性。与无保险，分娩日，收入和移民阶层相关的风险表明，考虑非生物医学因素在减少移民中紧急剖腹产的必要性。(C)2013年国际妇产科联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objective: To determine the predictors of emergency cesarean delivery among international migrant women. Methods: Between February 2006 and May 2009, 1025 postpartum migrant women were recruited from 12 hospitals in Toronto, Montreal, and Vancouver. Logistic regression was used to model migration, social, health service, and biomedical factors predictive of emergency cesarean. Results: Overall, 14% percent of participants underwent emergency cesarean. The greatest risk was for women having their first delivery (odds ratio [OR], 5.9; 95% confidence interval [CI], 3.1-11.3); newborns weighing 4000 g or more (OR,3.5; 95% CI, 1.9-6.5); no health insurance (OR, 2.8; 95% CI, 12-6.4); delivery on a Friday (OR, 2.2; 95% CI, 1.2-3.9); incomes of less than 30 000 Canadian dollars (OR, 1.9; 1.2-3.0); and induced labor (OR, 1.8; 95% CI, 1.1-3.0). Compared with immigrants, asylum seekers (OR, 0.3; 95% CI, 0.2-0.6) and refugees (OR, 0.5; 95% CI, 02-1.0) were protected against emergency cesarean. Conclusion: Indicators specific to, or more common among, migrants were informative in assessing the likelihood of emergency cesarean. The risk associated with being uninsured, day of delivery, income, and immigration class suggests the importance of considering non-biomedical factors in reducing the need for emergency cesarean among migrants. (C) 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.