Prenatal Care among Immigrant Spouses in Taiwan and Association with Pregnancy Outcomes

• Main Authors: Juo-Wen Liao, 廖若雯
• Other Authors: Herng-Ching Lin
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/69021154584538946061

碩士 === 臺北醫學大學 === 醫務管理學研究所 === 98 === Background: To ensure the maternal and fetal health, Taiwan''s National Health Insurance (NHI) provides ten prenatal care visits for free to the pregnant women. However, immigrant spouses and their children have increased and became a new ethnic group in Taiwan in recent years. Therefore, the goal of this study was to analyze the differences in prenatal care utilization and pregnancy outcome between immigrant spouses and Taiwan-born women. Further, to determine the relationship between prenatal care and pregnancy outcomes among pregnant immigrant women in Taiwan. Methods: The study was based on the childbirth reporting system and National Health Insurance Research Database, and only included the women who had singleton live births from 2005 to 2006 in Taiwan. The total sample size was 126,498 pregnant women, including 42,166 immigrant women, and 84,332 Taiwan-born women who were in accordance with the proportion of pregnant immigrant women’s age in stratified random sampling. The adequacy of prenatal care utilization was based on the Kessner Index and in accordance with the recommended time schedule of prenatal care visit from Taiwan''s NHI, and was classified into adequate, intermediate and inadequate. A Logistic regression analysis was then used to examine the association between the prenatal care and pregnancy outcomes among pregnant immigrant women in Taiwan. Results: The mean of age of immigrant women was 26.17, and about 92% of 42,166 pregnant immigrant women are from Vietnam, China and Indonesia. Compared with Taiwan-born women, foreign-born women had a lower rate of caesarean section, preterm labor, low birth weight and small-for-gestational-age infants. With regard to prenatal care utilization, the immigrant women and Taiwan-born women in the mean time of first prenatal care visit were13.49 weeks (SD=7.23) and 10.17 weeks (SD=3.84), respectively. The average number of prenatal care visits of immigrant women and Taiwan-born women were respectively 7.63 (SD=2.4) and 8.22 (SD=2.24). 69.27% of foreign-born women initiated prenatal care within 13 weeks, while 90.77% represent Taiwan-born women. Some 6.53% of foreign-born women received inadequate prenatal care and 1.01% for the other. Compared the foreign-born women who received adequate prenatal care, the foreign-born women received inadequate prenatal care was associated with an increased risk of preterm delivery (OR=1.532, p<0.001), low birth weight (OR=1.341, p<0.01) and small-for-gestational-age infants (OR=1.282, p<0.001). Conclusions: The foreign-born women in Taiwan were more likely to have their initiation prenatal care later and a higher rate of inadequate prenatal care. About foreign-born women, inadequate prenatal care had a higher risk of having preterm delivery, low birth weight and small-for-gestational-age newborns than those who received the adequate prenatal care. Therefore, it is to suggest that related public health units should provide assistance to immigrant spouse regarding prenatal care utilization in terms of the promotion of prenatal care utilization program.