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首页> 美国卫生研究院文献>Reproductive Health >Enrolling pregnant women in research: ethical challenges encountered in Lao PDR (Laos)
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Enrolling pregnant women in research: ethical challenges encountered in Lao PDR (Laos)

机译：孕妇参加研究：老挝人民民主共和国（老挝）遇到的伦理挑战

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Laos has the highest maternal mortality ratio in mainland Southeast Asia but there has been little research conducted with pregnant women. We aim to discuss ethical challenges in enrolling pregnant women in research as a part of large pregnancy cohort study in Laos. From 2013 to 2015, a prospective cohort study was conducted with 1000 pregnant women in a rural area of Vientiane, Laos, to determine whether fevers were associated with maternal morbidity and small for gestational age. Incidence of fever was 10% and incidence of small for gestational age was 12%. Level of education, cultural norms about family decision-making, and misconceptions about healthcare during pregnancy were three common issues encountered in enrolling pregnant women to this study. Only 47% of recruited women had completed primary school with no further education, which could affect the decisions women make to participate and remain in the study. Family decision-making is common in Laos; in some cases, we could not recruit pregnant women without agreement from their families. In Laos, many pregnant women and their families had strong beliefs in travelling during late pregnancy or losing small amount of blood (giving ~5 ml blood sample) could negatively impact their pregnancies. These misconceptions affected not only the quality of the study but also the women’s opportunities to access healthcare. Good engagement between the research team and study participants, and the provision of more health information to the community, were essential to reducing issues experienced in enrolling pregnant women in this study.
机译：老挝的孕产妇死亡率是东南亚大陆最高的，但是对孕妇的研究很少。我们的目的是讨论在老挝进行的大规模孕妇队列研究中，招收孕妇参加研究时遇到的伦理挑战。从2013年到2015年，在老挝万象的农村地区对1000名孕妇进行了一项前瞻性队列研究，以确定发烧是否与母亲发病率相关且对胎龄较小。发烧的发生率为10％，胎龄小的发生率为12％。教育水平，有关家庭决策的文化规范以及对怀孕期间医疗保健的误解是招收孕妇参加本研究的三个常见问题。只有47％的应征女性已经完成了初等教育而没有接受进一步的教育，这可能会影响女性做出的参与并继续学习的决定。家庭决策在老挝很普遍。在某些情况下，未经家人的同意，我们无法招募孕妇。在老挝，许多孕妇及其家人坚信怀孕后期旅行或流失少量血液（提供约5毫升血液样本）可能会对怀孕产生负面影响。这些误解不仅影响了研究质量，也影响了妇女获得医疗保健的机会。研究团队与研究参与者之间的良好参与以及向社区提供更多健康信息，对于减少在本研究中招募孕妇的经历至关重要。

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