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Erschienen in: Archives of Gynecology and Obstetrics 2/2018

25.10.2017 | Maternal-Fetal Medicine

Obstetric care quality indicators and outcomes based on the degree of acculturation of immigrants—results from a cross-sectional study in Berlin

verfasst von: Matthias David, Theda Borde, Silke Brenne, Babett Ramsauer, Larry Hinkson, Wolfgang Henrich, Oliver Razum, Jürgen Breckenkamp

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2018

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Abstract

Hypothesis

Acculturation is a complex, multidimensional process involving the integration of the traditional norms, values, and lifestyles of a new cultural environment. It is, however, unclear what impact the degree of acculturation has on obstetric outcomes.

Methods

Data collection was performed in 2011 and 2012 at three obstetric tertiary centers in Berlin, Germany. Standardized interviews (20–30 min.) were performed with support of evaluated questionnaires. The primary collected data were then linked to the perinatal data recorded at the individual clinics provided from the obstetric centers which correspond with the routinely centralized data collected for quality assurance throughout Germany. The questionnaire included questions on sociodemographic, health care, and migrant-related aspects. Migrant women and women with a migration background were assessed using the Frankfurt Acculturation Scale, a one-dimensional measurement tool to assess the degree of acculturation (15 items on language and media usage as well as integration into social networks).

Results

In summary, 7100 women were available for the survey (response rate of 89.6%) of which 3765 (53%) had a migration background. The probability of low acculturation is significantly (p < 0.001) associated with a lower level of German knowledge, a shorter period of residence, and lower education. Pregnant women with a low acculturation also had a significantly greater chance of having the first booking visit after 9 weeks of pregnancy and fewer ultrasound examinations during pregnancy. There is no significant difference depending on the degree of acculturation for the frequency of elective and emergency cesarean sections. The results of the logistic regression analyses for the examination of possible relationships between the degree of acculturation and obstetric parameters show no significant differences for prematurity, 5 min.-Apgar values > 7, arterial umbilical cord pH values > 7.00 and admissions to the neonatal unit.

Conclusions

In Berlin, among migrant women a low degree of acculturation may have an unfavorable effect on the utilization of pregnancy care provision. However, there were no relevant differences in obstetric outcome parameters in relation to the degree of acculturation within the migrant population of Berlin.
Literatur
2.
Zurück zum Zitat Berry JW (1990) Psychology of acculturation: understanding individuals moving between cultures. In: Brislin RW (ed) Applied cross-cultural psychology, vol 14. Sage, Newbury Park, pp 232–253 Berry JW (1990) Psychology of acculturation: understanding individuals moving between cultures. In: Brislin RW (ed) Applied cross-cultural psychology, vol 14. Sage, Newbury Park, pp 232–253
3.
Zurück zum Zitat Bourghis RY, Moise LC, Perreault S, Senécal S (1997) Towards an interactive acculturation model: a social psychological approach. Int J Psychol 32:369–386CrossRef Bourghis RY, Moise LC, Perreault S, Senécal S (1997) Towards an interactive acculturation model: a social psychological approach. Int J Psychol 32:369–386CrossRef
5.
Zurück zum Zitat Malmusi D (2015) Immigrants’ health and health inequality by type of integration policies in European countries. Eur J Pub Health 25:293–299CrossRef Malmusi D (2015) Immigrants’ health and health inequality by type of integration policies in European countries. Eur J Pub Health 25:293–299CrossRef
6.
Zurück zum Zitat Gissler M, Alexander S, MacFarlane A, Small R, Stray-Pedersen B, Zeitlin J, Zimbeck M, Gagnon A (2009) Stillbirths and infant deaths among migrants in industrialized countries. Acta Obstet Gynecol Scand 88:134–148CrossRefPubMed Gissler M, Alexander S, MacFarlane A, Small R, Stray-Pedersen B, Zeitlin J, Zimbeck M, Gagnon A (2009) Stillbirths and infant deaths among migrants in industrialized countries. Acta Obstet Gynecol Scand 88:134–148CrossRefPubMed
7.
Zurück zum Zitat Bollini P, Pampallona S, Wanner P, Kupelnick B (2009) Pregnancy outcome of migrant women and integration policy: a systematic review of the international literature. Soc Sci Med 68:452–461CrossRefPubMed Bollini P, Pampallona S, Wanner P, Kupelnick B (2009) Pregnancy outcome of migrant women and integration policy: a systematic review of the international literature. Soc Sci Med 68:452–461CrossRefPubMed
8.
Zurück zum Zitat Urquia ML, Frank JW, Moineddin R, Glazier RH (2010) Immigrants’ duration of residence and adverse birth outcomes: a population-based study. BJOG 117:591–601CrossRefPubMedPubMedCentral Urquia ML, Frank JW, Moineddin R, Glazier RH (2010) Immigrants’ duration of residence and adverse birth outcomes: a population-based study. BJOG 117:591–601CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Villalonga-Olives E, Kawachi I, von Steinbüchel N (2016) Pregnancy and birth outcomes among immigrant women in the US and Europe: a systematic review. J Immigrant Minority Health 1–19. doi:10.1007/s10903-016-0483-2 Villalonga-Olives E, Kawachi I, von Steinbüchel N (2016) Pregnancy and birth outcomes among immigrant women in the US and Europe: a systematic review. J Immigrant Minority Health 1–19. doi:10.​1007/​s10903-016-0483-2
10.
Zurück zum Zitat Zlot AI, Jackson DJ, Korenbrot C (2005) Association of acculturation with cesarean section among Latinas. Matern Child Health J 9:11–20CrossRefPubMed Zlot AI, Jackson DJ, Korenbrot C (2005) Association of acculturation with cesarean section among Latinas. Matern Child Health J 9:11–20CrossRefPubMed
11.
Zurück zum Zitat Ruiz RJ, Saade GR, Brown CEL, Nelson-Becker C, Tan AL, Bishop S, Bukowki R (2008) The effect of acculturation on progesterone/estriol ratios and preterm birth in Hispanics. Obstet Gynecol 111:309–316CrossRefPubMed Ruiz RJ, Saade GR, Brown CEL, Nelson-Becker C, Tan AL, Bishop S, Bukowki R (2008) The effect of acculturation on progesterone/estriol ratios and preterm birth in Hispanics. Obstet Gynecol 111:309–316CrossRefPubMed
12.
Zurück zum Zitat Rosenberg TJ, Pagan T, Chiasson MA (2005) A further examination of the “Epidemiologic Paradox”: birth outcomes among Latinas. J Nat Med Assoc 97:550–556 Rosenberg TJ, Pagan T, Chiasson MA (2005) A further examination of the “Epidemiologic Paradox”: birth outcomes among Latinas. J Nat Med Assoc 97:550–556
13.
Zurück zum Zitat Kang SM (2006) Measurement of acculturation, scale formats, and language competence. Their implications for adjustment. J Cross-Cultural Psychol 37:669–693 Kang SM (2006) Measurement of acculturation, scale formats, and language competence. Their implications for adjustment. J Cross-Cultural Psychol 37:669–693
14.
Zurück zum Zitat van Dick R, Wagner U, Adams C, Petzel T (2014) Einstellungen zur Akkulturation. Zusammenstellung sozialwissenschaftlicher Items und Skalen. doi:10.6102/zis155 van Dick R, Wagner U, Adams C, Petzel T (2014) Einstellungen zur Akkulturation. Zusammenstellung sozialwissenschaftlicher Items und Skalen. doi:10.​6102/​zis155
15.
Zurück zum Zitat Bongard S, Pogge SF, Arslaner H, Rohrmann S, Hodapp V (2002) Acculturation and cardiovascular reactivity of second-generation—Turkish migrants in Germany. J Psychosom Res 53:795–803CrossRefPubMed Bongard S, Pogge SF, Arslaner H, Rohrmann S, Hodapp V (2002) Acculturation and cardiovascular reactivity of second-generation—Turkish migrants in Germany. J Psychosom Res 53:795–803CrossRefPubMed
16.
Zurück zum Zitat Bongard S, Arslaner H, Pogge SF (2000) FRAKK-Fragebogeninstrument, o. O Bongard S, Arslaner H, Pogge SF (2000) FRAKK-Fragebogeninstrument, o. O
17.
Zurück zum Zitat Schenk L, Bau AM, Borde T, Butler J, Lampert T, Neuhauser H, Razum O, Weilandt C (2006) Mindestindikatorensatz zur Erfassung des Migrationsstatus. Empfehlungen für die epidemiologische Praxis. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 49:853–860CrossRefPubMed Schenk L, Bau AM, Borde T, Butler J, Lampert T, Neuhauser H, Razum O, Weilandt C (2006) Mindestindikatorensatz zur Erfassung des Migrationsstatus. Empfehlungen für die epidemiologische Praxis. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 49:853–860CrossRefPubMed
19.
Zurück zum Zitat Essén B, Bödker B, Sjöberg NO, Langhoff-Roos J, Greisen G, Gudmundsson S, Östergren PO (2002) Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services? BJOG 109:677–682CrossRefPubMed Essén B, Bödker B, Sjöberg NO, Langhoff-Roos J, Greisen G, Gudmundsson S, Östergren PO (2002) Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services? BJOG 109:677–682CrossRefPubMed
20.
Zurück zum Zitat Alderliesten ME, Vrijkotte TGM, Van der Wal MF, Bonsel GJ (2007) Late start of antenatal care among ethnic minorities in a large cohort of pregnant women. BJOG 114:1232–1239CrossRefPubMed Alderliesten ME, Vrijkotte TGM, Van der Wal MF, Bonsel GJ (2007) Late start of antenatal care among ethnic minorities in a large cohort of pregnant women. BJOG 114:1232–1239CrossRefPubMed
21.
Zurück zum Zitat Ny P, Dykes AK, Molin J, Dejin-Karlsson E (2007) Utilisation of antenatal care by country of birth in a multi-ethnic population: a four-year community-based study in Malmö, Sweden. Acta Obstet Gynecol Scand 86:805–813CrossRefPubMed Ny P, Dykes AK, Molin J, Dejin-Karlsson E (2007) Utilisation of antenatal care by country of birth in a multi-ethnic population: a four-year community-based study in Malmö, Sweden. Acta Obstet Gynecol Scand 86:805–813CrossRefPubMed
22.
Zurück zum Zitat Oberaigner W, Leitner H, Oberaigner K, Marth C, Pinzger G, Concin H, Steiner H, Hofmann H, Wagner T, Mörtl M, Ramoni A (2013) Migrants and obstetrics in Austria—applying a new questionnaire shows differences in obstetric care and outcome. Wien Klin Wochenschr 125:34–40CrossRefPubMed Oberaigner W, Leitner H, Oberaigner K, Marth C, Pinzger G, Concin H, Steiner H, Hofmann H, Wagner T, Mörtl M, Ramoni A (2013) Migrants and obstetrics in Austria—applying a new questionnaire shows differences in obstetric care and outcome. Wien Klin Wochenschr 125:34–40CrossRefPubMed
23.
Zurück zum Zitat Flynn PM, Foster EM, Brost BC (2011) Indicators of acculturation related to Somali refugee women’s birth outcomes in Minnesota. J Immigrant Minority Health 13:224–231CrossRef Flynn PM, Foster EM, Brost BC (2011) Indicators of acculturation related to Somali refugee women’s birth outcomes in Minnesota. J Immigrant Minority Health 13:224–231CrossRef
25.
Zurück zum Zitat Sørbye IK, Daltveit AK, Sundby J, Stoltenberg C, Vangen S (2015) Caesarean section by immigrants’ length of residence in Norway: a population-based study. Eur J Public Health 25:78–84CrossRefPubMed Sørbye IK, Daltveit AK, Sundby J, Stoltenberg C, Vangen S (2015) Caesarean section by immigrants’ length of residence in Norway: a population-based study. Eur J Public Health 25:78–84CrossRefPubMed
27.
Zurück zum Zitat Miller LS, Robinson JA, Cibula DA (2016) Healthy immigrant effect: preterm births among immigrants and refugees in Syracuse, NY. Matern Child Health J 20:484–493CrossRefPubMed Miller LS, Robinson JA, Cibula DA (2016) Healthy immigrant effect: preterm births among immigrants and refugees in Syracuse, NY. Matern Child Health J 20:484–493CrossRefPubMed
28.
Zurück zum Zitat Bakken K, Skjeldalet OA, Stray Pedersen B (2017) Obstetric outcomes of first- and second-generation Pakistani immigrants: a comparison study at a low-risk maternity ward in Norway. J Immigrant Minority Health. doi:10.1007/s10903-015-0329-3 Bakken K, Skjeldalet OA, Stray Pedersen B (2017) Obstetric outcomes of first- and second-generation Pakistani immigrants: a comparison study at a low-risk maternity ward in Norway. J Immigrant Minority Health. doi:10.​1007/​s10903-015-0329-3
Metadaten
Titel
Obstetric care quality indicators and outcomes based on the degree of acculturation of immigrants—results from a cross-sectional study in Berlin
verfasst von
Matthias David
Theda Borde
Silke Brenne
Babett Ramsauer
Larry Hinkson
Wolfgang Henrich
Oliver Razum
Jürgen Breckenkamp
Publikationsdatum
25.10.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 2/2018
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-017-4574-7

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