英格兰移民妇女的孕前健康：2018-2019年产科服务数据横截面分析

IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Migration and Health Pub Date : 2024-01-01 DOI:10.1016/j.jmh.2024.100250

Majel McGranahan , Elizabeth Augarde , Danielle Schoenaker , Helen Duncan , Sue Mann , Debra Bick , Felicity Boardman , Oyinlola Oyebode

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引用次数: 0

摘要

背景弱势移民妇女的围产期结果很差，但人们对她们的孕前健康状况却知之甚少。我们调查了处于弱势地位的移民妇女与非移民妇女在孕前健康方面的不平等现象。方法这项全国性横断面研究使用了英国国家医疗服务系统产科服务数据集（MSDS）1.5版中的数据，其中包括英国国家医疗服务系统的产科服务。研究纳入了在 2018 年 1 月 1 日至 2019 年 3 月 31 日期间预约产前检查的 652880 名妇女。66.2%（n = 432,022 人）的迁移类别数据可用。计算了处于弱势状况的可能移民（英语不是他们的第一语言，带有复杂社会因素（CSF））、非处于弱势状况的可能移民（英语不是他们的第一语言，不带有CSF）、处于弱势状况的可能非移民（英语是他们的第一语言，带有CSF）和非处于弱势状况的可能非移民（英语是他们的第一语言，不带有CSF）之间的孕前指标的比值比。CSF包括新移民、寻求庇护者、难民、阅读/讲英语有困难、酗酒和/或滥用药物、20 岁以下和/或遭受家庭虐待。在研究人口中，3.8%（25 070 名妇女）可能是处于弱势状况的移民，10.2%（66 783 名妇女）可能是非弱势状况的移民，5.6%（36 433 名妇女）可能是处于弱势状况的非移民，46.5%（303 737 名妇女）可能是非弱势状况的非移民，33.8%的移民类别数据缺失。与可能的非弱势移民相比，可能的弱势移民（n = 25,070 人）孕前不服用叶酸的几率是可能的非弱势移民的两倍多（几率比 2.15，95 % 置信区间 2.06-2.25）。他们以前出现产科并发症和体重不足的几率增加，但出现身体和精神健康状况（糖尿病和乙型肝炎除外）、吸烟、超重或肥胖的几率较低。

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Preconception health among migrant women in England: A cross-sectional analysis of maternity services data 2018–2019

Background

Perinatal outcomes are poor among migrant women in vulnerable situations, but little is known about their health preconception. We investigated preconception health inequalities between migrant women in vulnerable situations and non-migrant women.

Methods

This national cross-sectional study used data from the NHS Maternity Services Data Set (MSDS) version 1.5, incorporating NHS maternity services in England. All 652,880 women with an antenatal booking appointment between 1/4/2018 and 31/3/2019 were included. Migration category data were available for 66.2 % (n = 432,022). Odds ratios were calculated comparing preconception indicators among probable migrants in vulnerable situations (English not their first language with complex social factors (CSF)), probable migrants not in vulnerable situations (English not their first language without CSF), probable non-migrants in vulnerable situations (English their first language with CSF) and probable non-migrants not in vulnerable situations (English their first language without CSF). CSF include recent migrants, asylum seekers, refugees, difficulty reading/speaking English; alcohol and/or drugs misuse; aged under 20; and/or experiencing domestic abuse.

Findings

We identified 3.8 % (25,070 women) of the study population as probable migrants in vulnerable situations, 10.2 % (66,783 women) as probable migrants not in vulnerable situations, 5.6 % (36,433 women) as probable non-migrants in vulnerable situations, 46.5 % (303,737 women) as probable non-migrants not in vulnerable situations, and 33.8 % as having missing migration category data. Probable migrants in vulnerable situations (n = 25,070) had over twice the odds of not taking folic acid preconception compared to probable non-migrants not in vulnerable situations (odds ratio 2.15, 95 % confidence interval 2.06–2.25). They had increased odds of previous obstetric complications and being underweight, but lower odds of physical and mental health conditions (apart from diabetes and hepatitis b), smoking and overweight or obesity.

Interpretation

Inequalities exist across many preconception indicators, highlighting opportunities to improve preconception health in this population to reduce health inequalities and improve perinatal and neonatal outcomes.