Esther Tutty, Jordon Wimsett, Charlotte Oyston, Sue Tutty, Matire Harwood, Emelia Legget, Lynn Sadler
{"title":"奥克兰中部和南部地区孕前叶酸使用的不平等现象:产后避孕调查的二次分析。","authors":"Esther Tutty, Jordon Wimsett, Charlotte Oyston, Sue Tutty, Matire Harwood, Emelia Legget, Lynn Sadler","doi":"10.1071/HC23103","DOIUrl":null,"url":null,"abstract":"<p><p>Introduction In Aotearoa New Zealand (NZ), there is inequity in rates of neural tube defects (NTDs). Among Maaori, NTD occur in 4.58/10 000 live births, and for Pacific peoples, it is 4.09/10 000 live births; this is compared to 2.81/10 000 live births for non-Maaori, non-Pacific peoples. Aim To describe self-reported pre-pregnancy folic acid supplementation and to determine the association between pregnancy intendedness, ethnicity, parity, maternal age, care provider and pre-pregnancy folic acid supplementation. Methods Secondary analysis of postpartum survey data collected at Te Whatu Ora Te Toka Tumai and Counties Manukau birthing facilities in 2020 was conducted. Descriptive analyses explored pregnancy intendedness and self-reported folic acid use by demographic variables. Multivariable logistic regression explored independent associations between demographic variables and folic acid use among intended pregnancies. Results In total, 398 participants completed the survey. The response rate was (140/149) 94% at Counties Manukau and (258/315) 82% at Te Toka Tumai. Pre-pregnancy supplementation was reported by 182 of 398 participants (46%). Use was higher among those who intended their pregnancy (151/262, 58%) compared to those who were 'pregnancy ambivalent' (9/33, 27%) or did not intend to become pregnant (22/103, 21%). Factors independently associated with supplementation among intended pregnancies included: 'Other ethnicity' (European, Middle Eastern, Latin American, African) compared to Maaori (aOR 5.3 (95% CI 1.3, 21.8)), age ≥30 years compared to Discussion Low rates of pre-pregnancy folic acid supplementation exist in Auckland with significant ethnic disparity. Mandatory fortification of non-organic wheat is important, but supplementation is still recommended to maximally reduce risk.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Inequities in pre-pregnancy folic acid use in Central and South Auckland: secondary analysis from a postpartum contraception survey.\",\"authors\":\"Esther Tutty, Jordon Wimsett, Charlotte Oyston, Sue Tutty, Matire Harwood, Emelia Legget, Lynn Sadler\",\"doi\":\"10.1071/HC23103\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Introduction In Aotearoa New Zealand (NZ), there is inequity in rates of neural tube defects (NTDs). Among Maaori, NTD occur in 4.58/10 000 live births, and for Pacific peoples, it is 4.09/10 000 live births; this is compared to 2.81/10 000 live births for non-Maaori, non-Pacific peoples. Aim To describe self-reported pre-pregnancy folic acid supplementation and to determine the association between pregnancy intendedness, ethnicity, parity, maternal age, care provider and pre-pregnancy folic acid supplementation. Methods Secondary analysis of postpartum survey data collected at Te Whatu Ora Te Toka Tumai and Counties Manukau birthing facilities in 2020 was conducted. Descriptive analyses explored pregnancy intendedness and self-reported folic acid use by demographic variables. Multivariable logistic regression explored independent associations between demographic variables and folic acid use among intended pregnancies. Results In total, 398 participants completed the survey. The response rate was (140/149) 94% at Counties Manukau and (258/315) 82% at Te Toka Tumai. Pre-pregnancy supplementation was reported by 182 of 398 participants (46%). Use was higher among those who intended their pregnancy (151/262, 58%) compared to those who were 'pregnancy ambivalent' (9/33, 27%) or did not intend to become pregnant (22/103, 21%). Factors independently associated with supplementation among intended pregnancies included: 'Other ethnicity' (European, Middle Eastern, Latin American, African) compared to Maaori (aOR 5.3 (95% CI 1.3, 21.8)), age ≥30 years compared to Discussion Low rates of pre-pregnancy folic acid supplementation exist in Auckland with significant ethnic disparity. Mandatory fortification of non-organic wheat is important, but supplementation is still recommended to maximally reduce risk.</p>\",\"PeriodicalId\":16855,\"journal\":{\"name\":\"Journal of primary health care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2023-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of primary health care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1071/HC23103\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PRIMARY HEALTH CARE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of primary health care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1071/HC23103","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PRIMARY HEALTH CARE","Score":null,"Total":0}
引用次数: 0
摘要
导言:在新西兰奥特亚罗瓦地区(NZ),神经管畸形(NTDs)的发病率存在不平等现象。毛利人的神经管畸形发生率为 4.58/10,000,太平洋岛屿族裔的神经管畸形发生率为 4.09/10,000,而非毛利人和非太平洋岛屿族裔的神经管畸形发生率为 2.81/10,000。目的 描述自我报告的孕前叶酸补充情况,并确定怀孕意愿、种族、奇偶性、产妇年龄、护理提供者与孕前叶酸补充之间的关联。方法 对 2020 年在 Te Whatu Ora Te Toka Tumai 和 Counties Manukau 生育机构收集的产后调查数据进行二次分析。描述性分析根据人口统计学变量探讨了怀孕意愿和自我报告的叶酸使用情况。多变量逻辑回归探讨了人口统计学变量与计划妊娠中叶酸使用情况之间的独立关联。结果 共有 398 名参与者完成了调查。马努考县的回复率为(140/149)94%,特托卡图迈县的回复率为(258/315)82%。398 名参与者中有 182 人(46%)报告了孕前补充营养的情况。与 "怀孕矛盾 "者(9/33,27%)或不打算怀孕者(22/103,21%)相比,打算怀孕者使用补充剂的比例更高(151/262,58%)。与打算怀孕者补充营养素独立相关的因素包括其他种族"(欧洲人、中东人、拉丁美洲人、非洲人)与毛利人相比(aOR 5.3 (95% CI 1.3, 21.8)),年龄≥30 岁与讨论 在奥克兰,孕前叶酸补充率很低,而且存在明显的种族差异。强制强化非有机小麦非常重要,但仍建议补充叶酸,以最大限度地降低风险。
Inequities in pre-pregnancy folic acid use in Central and South Auckland: secondary analysis from a postpartum contraception survey.
Introduction In Aotearoa New Zealand (NZ), there is inequity in rates of neural tube defects (NTDs). Among Maaori, NTD occur in 4.58/10 000 live births, and for Pacific peoples, it is 4.09/10 000 live births; this is compared to 2.81/10 000 live births for non-Maaori, non-Pacific peoples. Aim To describe self-reported pre-pregnancy folic acid supplementation and to determine the association between pregnancy intendedness, ethnicity, parity, maternal age, care provider and pre-pregnancy folic acid supplementation. Methods Secondary analysis of postpartum survey data collected at Te Whatu Ora Te Toka Tumai and Counties Manukau birthing facilities in 2020 was conducted. Descriptive analyses explored pregnancy intendedness and self-reported folic acid use by demographic variables. Multivariable logistic regression explored independent associations between demographic variables and folic acid use among intended pregnancies. Results In total, 398 participants completed the survey. The response rate was (140/149) 94% at Counties Manukau and (258/315) 82% at Te Toka Tumai. Pre-pregnancy supplementation was reported by 182 of 398 participants (46%). Use was higher among those who intended their pregnancy (151/262, 58%) compared to those who were 'pregnancy ambivalent' (9/33, 27%) or did not intend to become pregnant (22/103, 21%). Factors independently associated with supplementation among intended pregnancies included: 'Other ethnicity' (European, Middle Eastern, Latin American, African) compared to Maaori (aOR 5.3 (95% CI 1.3, 21.8)), age ≥30 years compared to Discussion Low rates of pre-pregnancy folic acid supplementation exist in Auckland with significant ethnic disparity. Mandatory fortification of non-organic wheat is important, but supplementation is still recommended to maximally reduce risk.