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首页> 外文期刊>European Journal of Obstetrics, Gynecology and Reproductive Biology: An International Journal >Ethnic differences in perinatal mortality. A perinatal audit on the role of substandard care.
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Ethnic differences in perinatal mortality. A perinatal audit on the role of substandard care.

机译：围产期死亡率的种族差异。对不合格护理的作用进行围产期审核。

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OBJECTIVES: The objective was to investigate the contribution of substandard care to ethnic inequalities in perinatal mortality. STUDY DESIGN: Perinatal audit in Amsterdam, the Netherlands. The study population consisted of 137 consecutive perinatal death cases (16 weeks GA-28 days after delivery). A standardized procedure to establish the cause of death and substandard care by perinatal audit was developed. The main outcome measures were perinatal mortality rates in ethnic groups, cause of death classified by extended Wigglesworth classification, presence of substandard care (unlikely to be, possibly or likely to be related to perinatal death), and component of care considered to be substandard. RESULTS: In Surinamese and other non-Western mothers (mainly from Ghana) perinatal mortality, beyond 16 weeks' gestation, was statistically significantly higher than among native Dutch mothers. (4.01, 2.50, and 1.07%, respectively). In Surinamese and Moroccan mothers, we observed a higher rate of early pretermdeliveries. The prevalence of substandard care differed statistically significantly among ethnic groups (p=0.034), with the highest prevalence among Surinamese mothers. These differences were especially apparent in the prevalence of (more) maternal substandard care factors among Surinamese and Moroccan mothers. These factors consisted of a later start date for antenatal care or a later notification by the caregiver about obstetrical problems (e.g. rupturing of membranes, decrease in foetal movements). CONCLUSIONS: The higher perinatal mortality in Surinamese and other non-Western groups is mainly due to a higher rate of early preterm deliveries. No differences in care were observed among ethnic groups during labour and delivery. Among Surinamese mothers, however, the results indicate that substandard care with maternal involvement plays a role in explaining their higher perinatal mortality rates.
机译：目标：目的是调查不合标准的护理对围产期死亡率种族不平等的贡献。研究设计：荷兰阿姆斯特丹的围产期审核。研究人群包括137例连续的围产期死亡病例（分娩后16周GA-28天）。制定了通过围产期审核确定死亡原因和不合格护理的标准化程序。主要结果指标包括种族中的围产期死亡率，通过扩展的Wigglesworth分类进行分类的死亡原因，存在不合标准的护理（不太可能，可能或可能与围产期死亡相关）以及被认为不合标准的护理组成部分。结果：在苏里南和其他非西方母亲（主要来自加纳）中，妊娠16周以上的围产期死亡率在统计学上显着高于荷兰本土母亲。 （分别为4.01、2.50和1.07％）。在苏里南和摩洛哥的母亲中，我们发现早期早产的比率更高。在不同种族之间，不合格护理的患病率在统计学上有显着差异（p = 0.034），在苏里南母亲中患病率最高。这些差异在苏里南和摩洛哥母亲中（更多）孕产妇不合格护理因素的流行中尤为明显。这些因素包括产前护理的开始日期较晚或护理人员以后的有关产科问题的通知（例如胎膜破裂，胎儿运动减少）。结论：苏里南和其他非西方人群的围产期死亡率较高，主要是由于早期早产的比例较高。在分娩和分娩期间，各族裔之间在护理方面没有差异。然而，结果表明，在苏里南的母亲中，母亲参与的不合格护理在解释其较高的围产期死亡率中发挥了作用。

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