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首页> 外文期刊>Journal of women’s health >Trends in Early Prenatal Care Among Women with Pre-Existing Diabetes: Have Income Disparities Changed?
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Trends in Early Prenatal Care Among Women with Pre-Existing Diabetes: Have Income Disparities Changed?

机译：预先存在糖尿病患者早期产前护理的趋势：有收入差异变化？

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Background: Women with pre-existing diabetes are at high maternal risk for comorbidities and death, particularly when early prenatal care is not received. Low income is a known barrier to early prenatal care. It is unknown whether recent policies to expand access to prenatal care have reduced income disparities. We hypothesized that income disparities would be minimized and that the odds of receipt of first trimester prenatal care among women with pre-existing diabetes would become similar across income strata over time. Material and Methods: Using the Colorado birth certificate registry from 2007 to 2014, receipt of prenatal care was assessed retrospectively in 2,497 women with pre-existing diabetes. Logistic regression was used to examine the association between high ($50,000), medium ($25,000-50,000), and low ($25,000) income strata and receipt of first trimester prenatal care by birth year, adjusted for demographics. Results: High, medium, and low income represented 29.5%, 19.0%, and 51.5% of the cohort, respectively. Women with high income were more likely to receive first trimester care than women with low income from 2007 [adjusted odds ratio, 95% confidence interval: 2.16 (1.18, 3.96)] through 2013 [1.66 (1.01, 2.73)], but significant differences were no longer observed in 2014 [1.59 (0.89, 2.84)]. The likelihood of receiving first trimester prenatal care was not significantly different between medium- and low-income strata from 2007 [1.07 (0.66, 1.74)] through 2014 [0.77 (0.48, 1.23)]. Conclusions: From 2007 to 2013, women in Colorado with diabetes were more likely to receive early prenatal care if they were in the highest income stratum than in the lowest stratum. In 2014, receipt of first trimester care became equitable across all income strata. Future work should examine national patterns of income with receipt of prenatal care and outcomes among women with pre-existing diabetes.
机译：背景：具有预先存在的糖尿病的妇女是在未收到早期产前护理时的高母体风险。低收入是早期产前护理的已知障碍。尚不清楚最近的政策是否能够扩大对产前护理的机会减少收入差异。我们假设收入差距最小化，并且在预先存在的糖尿病患者中收到妊娠前孕妇产前护理的几率将在收入地层中变得相似。材料和方法：使用2007年至2014年的科罗拉多州出生证书注册处，在预先存在的糖尿病的2,497名妇女中回顾性评估产前护理。 Logistic回归用于检查高（＆ $ 50,000），中等（25,000-50,000美元）之间的关联，低（＆ 25,000美元）的收入地层以及诞生年份的第一个三个月产前护理，调整为人口统计学。结果：高，中等，低收入分别代表队列的29.5％，19.0％和51.5％。收入高收入的女性比2007年收入低的女性更容易获得第一个妊娠期护理[调整后的赔率比，95％置信区间：2.16（1.18,3.96）到2013 [1.66（1.01，2.73）]，但差异很大2014年不再观察到[1.59（0.89,2.84）]。从2007年的中低收入阶层接受妊娠期产前护理的可能性在2014年（0.77（0.66,1.74）]至2014年[0.77（0.48,1.23）]之间没有显着差异。结论：从2007年到2013年，如果他们在最高的地层中，科罗拉多患有糖尿病的女性患有糖尿病的妇女更有可能接受早期产前护理。 2014年，收到妊娠主要护理的首次收入地层公平。未来的工作应审查与预先存在的糖尿病患者的产前护理和孕产性的国家收入模式。

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