社会脆弱性概况,产前护理使用和怀孕结果之间的关联
Simon Crequit1, Konstantinos Chatzistergiou2, Gregory Bierry2
1Centre Hospitalier Intercommunal de Montreuil, 56 Boulevard de la Boissière, Montreuil, 93100, France. crequitsimon@gmail.com.
BMC pregnancy and childbirth
|June 22, 2023
概括
这项研究确定了五种与不充分使用产前护理和不良妊娠结果 (如早产和死产) 相关的社会脆弱性概况. 基于这些个人资料的个性化患者管理可以改善妊娠结果.
科学领域:
- 产科和妇科 产科和妇科
- 公共卫生 公共卫生
- 社会学 社会学 社会学
背景情况:
- 评估社会脆弱性是复杂的,之前的研究将社会贫困指标与不良妊娠结果联系起来.
- 社会贫困的地理和行政指标与不利的母亲和婴儿健康有关.
- 了解社会脆弱性的多面性质对于改善围产期健康平等至关重要.
研究的目的:
- 评估不同社会脆弱性概况与产前护理利用之间的关联.
- 调查社会脆弱性概况与不良妊娠结果之间的关系,包括早产,对于妊娠年龄来说小,死产,医疗堕胎和晚期流产.
- 确定特定的社会脆弱性概况,这些概况为不良妊娠结果带来最高风险.
主要方法:
- 在2020年1月至2021年12月期间,对7643名妇女进行了回顾性研究,在14个妊娠周后分娩单独婴儿.
- 多元组件分析 (MCA) 和对主要组件的层次聚类 (HCPC) 用于根据社会隔离,住房,收入,保险,移民身份,语言障碍,暴力,依赖,心理脆弱性,成和精神疾病等因素来定义社会脆弱性概况.
- 使用后勤和Poisson回归模型来分析社会脆弱性概况和怀孕结果之间的关联,并根据孕产妇和医疗因素进行调整.
主要成果:
- 确定了五个不同的社会脆弱性概况,其中概况1代表了最低的脆弱性.
- 个人资料2-5与不充分的产前护理使用有显著的关联,个人资料5显示的风险最高 (aOR=3.14).
- 较高的脆弱性概况与早产风险增加有关 (概况2,aOR=4.64),比妊娠年龄小 (概况5,aOR=1.60),晚期流产 (概况2,aIRR=7.39),死产 (概况2,aIRR=10.9),医疗堕胎 (概况2,aIRR=12.65).
结论:
- 该研究成功地确定了五个临床相关的社会脆弱性概况,每一个都与不同程度的不充分的产前护理和不良妊娠结果有关.
- 这些发现强调了在临床实践中认识到各种社会脆弱性的重要性.
- 调整患者管理策略以适应个体的社会脆弱性概况,有可能提高怀孕护理并减轻不良后果.
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