Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services?
Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services?
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DOI：
10.1016/s1470-0328(02)01077-7
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发表时间：
2002-06-01
影响因子：
5.8
通讯作者：
Östergren, PO
中科院分区：
文献类型：
--
作者：
Essén, B;Bödker, B;Östergren, PO
Objective To test the hypothesis that suboptimal factors in peripheral care services causing in peripheral deaths are more common among immigrant mothers from the Horn of Africa，when compared with Swedish mothers.Design一项围产期审计，比较居住在瑞典的非洲移民儿童围产期死亡的病例，对瑞典本地妇女的病例进行分层抽样。1990-1996年在瑞典医院分娩的东非移民妇女中有3例围产期死亡，瑞典本地妇女中有126例围产期死亡。死亡时间和类型的hospitalsatived.Main结果措施次优因素在围产期保健服务，归类为孕产妇，医疗保健和communication.Results率的次优因素可能导致潜在的可避免的围产期死亡显着较高的非洲移民。与瑞典母亲相比，在产前死亡组中，比值比（OR）为6.2（95% CI 1.9-20）;分娩死亡的OR为13（95% CI 1.1-166）;新生儿死亡的OR为18（95% CI 3.3-100）。最常见的因素是延迟寻求医疗保健，母亲拒绝剖腹产，宫内生长受限（IUGR）的监测不足，药物治疗不足，误解的心脏分娩（CTG）和人际miscommunication.Conclusions次优因素围产期保健可能导致围产期死亡的显着更常见的东非比本地瑞典母亲，提供洞察社会文化差异的怀孕策略，但也在瑞典围产期保健系统的某些保健程序的次优性能。
Objective To test the hypothesis that suboptimal factors in perinatal care services resulting in perinatal deaths were more common among immigrant mothers from the Horn of Africa, when compared with Swedish mothers.Design A perinatal audit, comparing cases of perinatal deaths among children of African immigrants residing in Sweden, with a stratified sample of cases among native Swedish women.Population and setting Sixty-three cases of perinatal deaths among immigrant east African women delivered in Swedish hospitals in 1990-1996, and 126 cases of perinatal deaths among native Swedish women. Time of death and type of hospital were stratified.Main outcome measures Suboptimal factors in perinatal care services, categorised as maternal, medical care and communication.Results The rate of suboptimal factors likely to result in potentially avoidable perinatal death was significantly higher among African immigrants. In the group of antenatal deaths, the odds ratio (OR) was 6.2 (95% Cl 1.9-20); the OR for intrapartal deaths was 13 (95% Cl 1.1-166); and the OR for neonatal deaths was 18 (95% Cl 3.3-100), when compared with Swedish mothers. The most common factors were delay in seeking health care, mothers refusing caesarean sections, insufficient surveillance of intrauterine growth restriction (IUGR), inadequate medication, misinterpretation of cardiotocography (CTG) and interpersonal miscommunication.Conclusions Suboptimal factors in perinatal care likely to result in perinatal death were significantly more common among east African than native Swedish mothers, affording insight into socio-cultural differences in pregnancy strategies, but also the suboptimal performance of certain health care routines in the Swedish perinatal care system.