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首页> 外文期刊>Contraception and reproductive medicine. >Demographic analysis of a low resource, socioculturally diverse urban community presenting for infertility care in a United States public hospital
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Demographic analysis of a low resource, socioculturally diverse urban community presenting for infertility care in a United States public hospital

机译：在美国公立医院中进行不育治疗的资源贫乏，社会文化多元的城市社区的人口统计分析

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BackgroundInfertility is a prevalent disease of reproductive health that exerts an impact on an estimated 80 million people worldwide. For many, involuntary childlessness becomes a central and preoccupying issue in their lives, the impact of which is exacerbated by lack of access to basic care and treatment. These effects maybe further magnified among immigrant communities, a growing but highly marginalized population that has been shown in other areas of reproductive health to experience worse health outcomes and delays in access to care. To date, few studies have examined the unique medical and sociocultural considerations of infertility among immigrant populations in the United States. MethodsOur study is a cross-sectional analysis of women presenting for infertility evaluation at a county hospital serving a low resource, socioculturally diverse largely immigrant communities in comparison to infertile women from a largely affluent population presenting to a high resource, comprehensive fertility center. We employed surveys to evaluate demographics and socioeconomic parameters as well as ed data from medical records to obtain infertility diagnoses. Multivariate regression analysis was applied to examine impact of sociocultural factors as predictors of duration of untreated infertility disease burden experienced by patients. ResultsEighty-seven women were included in our analysis. In the county hospital/low resource clinic (LR), the mean age was 32.9?±?4.9 vs 36.4?±?6.3?years in the fee-for-service/high resource clinic (HR). The mean reported duration of infertility in LR and HR patients was 3.4?±?3.0 vs 2.3?±?1.5?years. 70% of LR patients were monolingual non-English speakers vs 5.4% of HR patients. 59% of LR patients reported an annual household income of less than $25,000 and 70% did not have a college degree. 81.1% of HR patients reported an income of higher than $100,000, and 81.1% had completed college or graduate school. The most common infertility diagnosis in the LR was anovulation (38%) and tubal factor (28%) compared to diminished ovarian reserve (37.8%) and male factor (51.4%) in the HR. After controlling for age at the initiation of pregnancy attempt, lower education level, lower income, and immigrant status were significantly correlated with a longer duration of infertility. ConclusionsWomen presenting for infertility care to a low resource county medical center represent immigrant communities and are generally of younger age, but with a longer duration of infertility. This study identifies lower educational level, income, and immigrant status as barriers in access to care.
机译：背景技术不育是一种普遍存在的生殖健康疾病，对全世界约8000万人产生影响。对于许多人来说，非自愿的无子女成为他们生活中的核心和头等大事，由于缺乏基本的护理和治疗，其影响更加严重。这些影响在移民社区中可能会进一步放大，这是一个正在增长但处于高度边缘化的人口，已在生殖健康的其他领域显示出其健康状况较差和就医时间延迟。迄今为止，很少有研究检查美国移民人口中不育的独特医学和社会文化因素。方法我们的研究是横断面分析的，这些妇女在县城医院进行不育评估，而该县医院的资源贫乏，社会文化多样性，主要是移民社区，而来自大量富裕人群的不育妇女则需要资源丰富，综合的生育中心。我们采用了调查来评估人口统计学和社会经济参数以及医疗记录中的ed数据，以获取不育诊断。多变量回归分析用于检查社会文化因素的影响，作为患者经历未治疗的不育疾病负担持续时间的预测指标。结果我们的分析中包括了87名女性。在县医院/低资源诊所（LR）中，平均年龄为32.9±4.9岁，而有偿服务/高资源诊所（HR）为36.4±6.3岁。据报道，LR和HR患者的不育持续时间平均为3.4？±？3.0？年，而2.3？±1.5 ??年。 LR患者中有70％是说英语的非英语使用者，而HR患者是5.4％。 59％的LR患者报告家庭年收入低于$ 25,000，而70％的人没有大学学历。 81.1％的HR患者报告收入高于$ 100,000，并且81.1％的大学或研究生院毕业。 LR中最常见的不育诊断是无排卵（38％）和输卵管因素（28％），而HR中卵巢储备减少（37.8％）和男性因素（51.4％）。在开始尝试怀孕的年龄之后，较低的受教育程度，较低的收入和移民状况与较长的不育时间密切相关。结论到资源贫乏的县医疗中心就诊的不孕妇女代表移民社区，一般年龄较小，但不孕时间较长。这项研究确定较低的教育水平，收入和移民身份是获得护理的障碍。

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