Obstetrical Complications in Venezuelan Refugee and Migrant Women: Analysis of Ecuadorian National Hospital Discharge Data, 2018-2021.

IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Journal of Immigrant and Minority Health Pub Date : 2024-10-01 Epub Date: 2024-05-03 DOI:10.1007/s10903-024-01600-x
M Margaret Weigel, Rodrigo X Armijos
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引用次数: 0

Abstract

An estimated 7.7 million Venezuelans have fled a severe humanitarian crisis in their country, most (70%) to other middle-income host countries in the same Andean region. Migration-related exposures during periconception and other critical gestational periods can adversely impact maternal-perinatal outcomes. Emerging evidence suggests that Venezuelan refugee and migrant women (VRMW) who migrate to Andean host countries are at-risk for delivering preterm and low birthweight infants and for Cesarean-sections. However, relatively few studies have examined obstetrical complications that could contribute to these or other short- and longer-term health outcomes of VRMW and/or their offspring. Our exploratory study analyzed four recent years of national hospital discharge data (2018-2021) from Ecuador to compare the primary discharge diagnoses of VRMW (n = 29,005) and Ecuadorian nationals (n = 1,136,796) for ICD-10 O code obstetrical complications related to or aggravated by pregnancy, childbirth, or the puerperium. Our findings indicated that VRMW were hospitalized for 0.5 days longer than Ecuadorian reference group women and they had higher adjusted odds (aOR) for a primary discharge diagnosis for obstetrical complications including preeclampsia (aOR:1.62, 95% CI:1.55,1.69), preterm labor (aOR:1.20, 95% CI:1.11,1.31), premature rupture of membranes (aOR: 1.72, 95% CI:1.63,1.83), oligohydraminos (aOR:1.24, 95% CI:1.12,1.36), obstructed labor (aOR: 1.39, 95% CI:1.31,1.47), perineal lacerations/other obstetric trauma (aOR:1.76, 95% CI:1.63, 1.91), STIs (aOR:2.59, 95% CI:1.29,2.92), anemia (aOR:1.33, 95% CI:1.24,1.42), and ectopic pregnancy (aOR:1.16 95% CI:1.04,1.28). They had similar aOR for diagnosed gestational diabetes and spontaneous abortion (SAB) compared to the reference group but a reduced aOR for genitourinary infections (aOR:0.79, 95% CI:0.74,0.84) and early pregnancy hemorrhage not ending in SAB (aOR:0.43, 95% CI:0.36,0.51). Our findings underscore the vulnerability of VRMW for a number of potentially serious obstetrical complications with the potential to adversely impact the short- and longer-term health of mothers and their offspring. Future studies should collect more detailed information on the migration status, experiences, and exposures of MRMW that influence their risk for obstetrical complications. These are needed to expand our findings to better understand why they have excess risk for these and to inform social and public health policies, programs and targeted interventions aimed at reducing the risk of this vulnerable refugee and migrant group.

委内瑞拉难民和移民妇女的产科并发症:2018-2021年厄瓜多尔全国医院出院数据分析》。
据估计,有 770 万委内瑞拉人逃离了本国严重的人道主义危机,其中大多数(70%)逃往同属安第斯地区的其他中等收入收容国。在围孕期和其他关键妊娠期,与移民相关的暴露会对孕产妇围产期结局产生不利影响。新出现的证据表明,移居到安第斯收容国的委内瑞拉难民和移民妇女(VRMW)面临着分娩早产儿、低出生体重儿和剖腹产的风险。然而,相对较少的研究对可能导致这些或其他短期和长期健康后果的产科并发症进行了研究。我们的探索性研究分析了厄瓜多尔最近四年(2018-2021 年)的全国出院数据,比较了 VRMW(n = 29,005 人)和厄瓜多尔国民(n = 1,136,796 人)对与怀孕、分娩或产褥期有关或因怀孕、分娩或产褥期而加重的 ICD-10 O 编码产科并发症的主要出院诊断。我们的研究结果表明,与厄瓜多尔参照组妇女相比,越南裔妇女的住院时间延长了 0.5 天,而且她们的主要出院诊断为产科并发症,包括子痫前期(aOR:1.62, 95% CI:1.55,1.69)、早产(aOR:1.20, 95% CI:1.11,1.31)、胎膜早破(aOR: 1.72,95% CI:1.63,1.83)、低血氨(aOR:1.24,95% CI:1.12,1.36)、难产(aOR:1.39,95% CI:1.31,1.47)、会阴裂伤/其他产科创伤(aOR:1.76,95% CI:1.63,1.91)、性传播感染(aOR:2.59,95% CI:1.29,2.92)、贫血(aOR:1.33,95% CI:1.24,1.42)和宫外孕(aOR:1.16,95% CI:1.04,1.28)。与参照组相比,他们在确诊妊娠糖尿病和自然流产(SAB)方面的 aOR 值相似,但在泌尿生殖系统感染(aOR:0.79,95% CI:0.74,0.84)和未导致自然流产的早期妊娠出血(aOR:0.43,95% CI:0.36,0.51)方面的 aOR 值较低。我们的研究结果表明,VRMW 容易引发一些潜在的严重产科并发症,可能会对母亲及其后代的短期和长期健康造成不利影响。未来的研究应收集更多有关影响产妇产科并发症风险的移民身份、经历和暴露的详细信息。我们需要这些信息来扩展我们的研究结果,以便更好地了解她们为何会有更高的产科并发症风险,并为旨在降低这一弱势难民和移民群体风险的社会和公共卫生政策、计划和有针对性的干预措施提供信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Immigrant and Minority Health
Journal of Immigrant and Minority Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
3.70
自引率
5.30%
发文量
104
期刊介绍: Journal of Immigrant and Minority Health is an international forum for the publication of peer-reviewed original research pertaining to immigrant health from contributors in many diverse fields including public health, epidemiology, medicine and nursing, anthropology, sociology, population research, immigration law, and ethics. The journal also publishes review articles, short communications, letters to the editor, and notes from the field.
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