Small for Gestational Age Newborns in French Guiana: The Importance of Health Insurance for Prevention

Lindsay Osei, Nicolas Vignier, Mathieu Nacher, Juliette Laumonnier, Claude Conan, Loreinzia Clarke, Akoï Koivogui, Sabrina Covis, Luciano Valony, C. Basurko, Solène Wiedner-Papin, Alain Prual, Thierry Cardoso, Malika Leneuve-Dorilas, L. Alcouffe, N. Hcini, Stéphanie Bernard, Tiphanie Succo, Françoise Vendittelli, N. Elenga
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Abstract

Objectives: Small for gestational age (SGA) newborns have a higher risk of poor outcomes. French Guiana (FG) is a territory in South America with poor living conditions. The objectives of this study were to describe risk factors associated with SGA newborns in FG.Methods: We used the birth cohort that compiles data from all pregnancies that ended in FG from 2013 to 2021. We analysed data of newborns born after 22 weeks of gestation and/or weighing more than 500 g and their mothers.Results: 67,962 newborns were included. SGA newborns represented 11.7% of all newborns. Lack of health insurance was associated with SGA newborns (p < 0.001) whereas no difference was found between different types of health insurance and the proportion of SGA newborns (p = 0.86). Mothers aged less than 20 years (aOR = 1.65 [1.55–1.77]), from Haiti (aOR = 1.24 [1.11–1.39]) or Guyana (aOR = 1.30 [1.01–1.68]) and lack of health insurance (aOR = 1.24 [1.10–1.40]) were associated with SGA newborns.Conclusion: Immigration and precariousness appear to be determinants of SGA newborns in FG. Other studies are needed to refine these results.
法属圭亚那的小于胎龄新生儿:医疗保险对预防的重要性
目的:胎龄小的新生儿(SGA)出现不良后果的风险较高。法属圭亚那(FG)是南美洲的一块领土,生活条件很差。本研究旨在描述法属圭亚那 SGA 新生儿的相关风险因素:我们使用了出生队列数据,该数据汇集了 2013 年至 2021 年期间在法属圭亚那结束的所有妊娠的数据。我们分析了妊娠 22 周后出生和/或体重超过 500 克的新生儿及其母亲的数据:共纳入 67 962 名新生儿。SGA新生儿占所有新生儿的11.7%。缺乏医疗保险与 SGA 新生儿有关(p < 0.001),而不同类型的医疗保险与 SGA 新生儿比例之间没有差异(p = 0.86)。年龄小于 20 岁(aOR = 1.65 [1.55-1.77])、来自海地(aOR = 1.24 [1.11-1.39])或圭亚那(aOR = 1.30 [1.01-1.68])以及缺乏医疗保险(aOR = 1.24 [1.10-1.40])的母亲与 SGA 新生儿有关:结论:移民和不稳定因素似乎是 FG SGA 新生儿的决定因素。结论:移民和不稳定性似乎是肥胖症新生儿的决定因素,还需要其他研究来完善这些结果。
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