Perinatal and infant health outcomes among neonates born to aboriginal parents in Taiwan.

Yu-Hsun Chang, Pau-Chung Chen, Chia-Jung Hsieh, Suh-Fang Jeng, Hua-Fang Liao, Yi-Ning Su, Shio-Jean Lin, Hung-Chieh Chou, Yi-Ping Lin, Wu-Shiun Hsieh
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Abstract

Background: Poor health outcomes among neonates born to aborigines has been reported in many countries. This study was aimed to examine the nationwide characteristics of live births, adverse birth outcomes, and age-specific mortality among neonates born to non-aboriginal and aboriginal parents in Taiwan.

Methods: All neonates born alive during the period of 2000 to 2003 in Taiwan were included. The adverse birth outcomes including low birth weight, preterm, and small-for-gestational-age births, and age-specific mortality were obtained. Logistic regression analysis was used to estimate odds ratios for parental ethnicity in relation to birth outcomes, while Cox's proportional hazards regression models were used to estimate hazard ratios for parental ethnicity in relation to age-specific infant deaths.

Results: A total of 947,317 live births were included that consisted of 9,381 born to aboriginal mothers, 6,429 born to aboriginal fathers, and 15,354 born to aboriginal parents. There was a gradual increase in the risk of having a baby with low birth weight, preterm, or small for gestational age born to the four parental aboriginal ethnicity groups: non-aboriginal parents, aboriginal mother only, aboriginal father only, and aboriginal parents. Similar trends were also found for early neonatal, neonatal, and infant mortalities after stratification of residential areas. The neonates born to both aboriginal parents with residence in rural or mountain areas were at highest risk of adverse birth outcomes and age-specific mortality.

Conclusions: Our results demonstrated that aboriginality and residential area are important risk factors for adverse perinatal and infant outcomes.

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台湾原住民父母所生新生儿围产期及婴儿健康状况。
背景:许多国家都报告了土著居民所生新生儿健康状况不佳的情况。摘要本研究旨在探讨台湾非原住民与原住民父母所生新生儿的活产特征、不良出生结局与年龄特异性死亡率。方法:选取2000 ~ 2003年台湾地区所有活产新生儿为研究对象。不良出生结局包括低出生体重、早产、小胎龄出生和年龄特异性死亡率。使用逻辑回归分析来估计父母种族与出生结局相关的优势比,而使用Cox比例风险回归模型来估计父母种族与特定年龄婴儿死亡相关的风险比。结果:共纳入947317例活产,其中原住民母亲9381例,原住民父亲6429例,原住民父母15354例。四种父母的原住民族群:非原住民父母、纯原住民母亲、纯原住民父亲和纯原住民父母,生出低出生体重、早产或小于胎龄婴儿的风险逐渐增加。类似的趋势也发现了早期新生儿,新生儿和婴儿死亡率后的住宅区分层。居住在农村或山区的原住民父母所生的新生儿出现不良出生结局和特定年龄死亡率的风险最高。结论:我们的研究结果表明,原住民和居住区域是围产儿和婴儿不良结局的重要危险因素。
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