Abstract：
OBJECTIVE: International studies show conflicting evidence regarding the perinatal outcome of immigrant women with and without refugee status compared to non-immigrant women. There are few studies about the situation in Germany. The research question of this article is: Is the perinatal outcome (Apgar, UApH (umbilical artery pH), NICU (neontatal intensive care unit) transfer, c-section rate, preterm birth, macrosomia, maternal anemia, higher degree perinatal tear, episiotomy, epidural anesthesia) associated with socio-demographic/clinical characteristics (migration status, language skills, household income, maternal education, parity, age, body mass index (BMI))?
METHODS: In the Pregnancy and Obstetric Care for Refugees (PROREF)-study (subproject of the research group PH-LENS), funded by the German Research Foundation (DFG), women giving birth in three centers of tertiary care in Berlin were interviewed with the modified Migrant Friendly Maternity Care Questionnaire between June 2020 and April 2022. The interview data was linked to the hospital charts. Data analysis was descriptive and logistic regression analysis was performed to find associations between perinatal outcomes and migration data.
RESULTS: During the research period 3420 women (247 with self-defined (sd) refugee status, 1356 immigrant women and 1817 non-immigrant women) were included. Immigrant women had a higher c-section rate (36.6% vs. 33.2% among non-immigrant women and 31.6% among women with sd refugee status, p = 0.0485). The migration status did not have an influence on the umbilical artery pH, the preterm delivery rate and the transfer of the neonate to the intensive care unit. Women with self-defined refugee status had a higher risk for anemia (31.9% vs. 26.3% immigrant women and 23.4% non-immigrant women, p = 0.0049) and were less often offered an epidural anesthesia for pain control during vaginal delivery (42.5% vs. 54% immigrant women and 52% non-immigrant women, p = 0.0091). In the multivariate analysis maternal education was explaining more than migration status.
CONCLUSIONS: Generally, the quality of care for immigrant and non-immigrant women in Berlin seems high. The reasons for higher rate of delivery via c-section among immigrant women remain unclear. Regardless of their migration status women with low degree of education seem at increased risk for anemia.
METHODS: In the Pregnancy and Obstetric Care for Refugees (PROREF)-study (subproject of the research group PH-LENS), funded by the German Research Foundation (DFG), women giving birth in three centers of tertiary care in Berlin were interviewed with the modified Migrant Friendly Maternity Care Questionnaire between June 2020 and April 2022. The interview data was linked to the hospital charts. Data analysis was descriptive and logistic regression analysis was performed to find associations between perinatal outcomes and migration data.
RESULTS: During the research period 3420 women (247 with self-defined (sd) refugee status, 1356 immigrant women and 1817 non-immigrant women) were included. Immigrant women had a higher c-section rate (36.6% vs. 33.2% among non-immigrant women and 31.6% among women with sd refugee status, p = 0.0485). The migration status did not have an influence on the umbilical artery pH, the preterm delivery rate and the transfer of the neonate to the intensive care unit. Women with self-defined refugee status had a higher risk for anemia (31.9% vs. 26.3% immigrant women and 23.4% non-immigrant women, p = 0.0049) and were less often offered an epidural anesthesia for pain control during vaginal delivery (42.5% vs. 54% immigrant women and 52% non-immigrant women, p = 0.0091). In the multivariate analysis maternal education was explaining more than migration status.
CONCLUSIONS: Generally, the quality of care for immigrant and non-immigrant women in Berlin seems high. The reasons for higher rate of delivery via c-section among immigrant women remain unclear. Regardless of their migration status women with low degree of education seem at increased risk for anemia.
摘要：
目的：国际研究表明，与非移民妇女相比，有和没有难民身份的移民妇女的围产期结局相互矛盾。关于德国情况的研究很少。本文的研究问题是：围产期结局(Apgar，UApH（脐动脉pH），NICU（新生儿重症监护病房）转院，c-截面率，早产,巨大儿,产妇贫血,较高程度的围产期撕裂，会阴切开术,硬膜外麻醉)与社会人口统计学/临床特征(迁移状态，语言技能,家庭收入,母亲教育,奇偶校验，年龄,体重指数（BMI））？
方法：在难民的怀孕和产科护理（PROREF）研究（研究组PH-LENS的子项目）中，由德国研究基金会（DFG）资助，在2020年6月至2022年4月期间,在柏林三个三级保健中心分娩的妇女接受了修改后的移民友好型产妇护理问卷的采访.访谈数据与医院图表相关联。数据分析是描述性的，并进行逻辑回归分析以发现围产期结局与迁移数据之间的关联。
结果：在研究期间，3420名妇女（247名具有自定义（sd）难民身份，包括1356名移民妇女和1817名非移民妇女）。移民女性的剖腹产率较高(36.6%vs.33.2%的非移民妇女和31.6%的具有sd难民身份的妇女，p=0.0485)。迁移状态对脐动脉pH值没有影响，早产率和新生儿转移到重症监护病房。具有自我定义的难民身份的女性患贫血的风险较高(31.9%vs.26.3％的移民妇女和23.4％的非移民妇女，p=0.0049），并且在阴道分娩期间很少使用硬膜外麻醉来控制疼痛（42.5％vs.54％的移民妇女和52％的非移民妇女，p=0.0091）。在多变量分析中，母亲教育解释的不仅仅是移民状况。
结论：一般来说，柏林对移民和非移民妇女的护理质量似乎很高。移民妇女剖腹产率较高的原因仍不清楚。无论其移民地位如何，受教育程度低的妇女似乎患贫血的风险增加。
方法：在难民的怀孕和产科护理（PROREF）研究（研究组PH-LENS的子项目）中，由德国研究基金会（DFG）资助，在2020年6月至2022年4月期间,在柏林三个三级保健中心分娩的妇女接受了修改后的移民友好型产妇护理问卷的采访.访谈数据与医院图表相关联。数据分析是描述性的，并进行逻辑回归分析以发现围产期结局与迁移数据之间的关联。
结果：在研究期间，3420名妇女（247名具有自定义（sd）难民身份，包括1356名移民妇女和1817名非移民妇女）。移民女性的剖腹产率较高(36.6%vs.33.2%的非移民妇女和31.6%的具有sd难民身份的妇女，p=0.0485)。迁移状态对脐动脉pH值没有影响，早产率和新生儿转移到重症监护病房。具有自我定义的难民身份的女性患贫血的风险较高(31.9%vs.26.3％的移民妇女和23.4％的非移民妇女，p=0.0049），并且在阴道分娩期间很少使用硬膜外麻醉来控制疼痛（42.5％vs.54％的移民妇女和52％的非移民妇女，p=0.0091）。在多变量分析中，母亲教育解释的不仅仅是移民状况。
结论：一般来说，柏林对移民和非移民妇女的护理质量似乎很高。移民妇女剖腹产率较高的原因仍不清楚。无论其移民地位如何，受教育程度低的妇女似乎患贫血的风险增加。
