| 摘要: | 中文摘要
目的：本研究主要是探討影響台灣地區新移民產婦剖腹產率之相關因素以及本國籍與外籍產婦其生產結果及生產方式之差異性，並探討影響不同國籍產婦剖腹產婦率之因素。
材料與方法：本研究採次級資料分析，資料來源為「行政院衛生署國民健康局出生通報資料庫」，研究對象為2004年全年生產之產婦，包括本國籍為189,392人（佔86.26％），大陸籍為11,603人（佔5.28％），東南亞籍18,197人（佔8.29％）。以卡方檢定（Chi-Square test）及變異數分析的統計方式來檢視不同國籍產婦間差異之情形，並利用羅吉斯迴歸分析，探討影響新移民產婦剖腹產率之相關因素。
結果：在剖腹產率方面，三個族群呈現明顯的差異（P<0.0001）。其中本國籍的剖腹產率為34.63％最高，大陸籍次之（26.65％），而東南亞籍之剖腹產最低（19.87％）。產婦年齡方面，本國籍（平均為31.98歲）和大陸籍（平均為30.84歲）的年齡較東南亞籍（平均為27.12歲）為高，且具有顯著差異。不同國籍產婦與新生兒的健康狀況並無顯著差異。羅吉斯迴歸分析結果發現產婦國籍（OR：1，0.686，0.468）、生產胎數≧3胎（OR：>999.99）、居住在高屏區（OR：1.175）、產婦年齡≧35歲（OR：1.908）、生產週數<37週者（OR：1.914）、過重或過輕的新生兒體重（OR：1.824，2.773）、新生兒第一分鐘及第五分鐘健康指數<7分（OR：2.601，2.235）均為影響剖腹產率之因素。而醫院及診所的剖腹產率無差異性，但研究中發現高屏區之剖腹產率為最高（OR：1.175）。
結論：本研究於控制母親年齡、新生兒體重及健康因素後，發現國籍及居住地區是影響剖腹產率的重要因素，因此，產婦非醫療因素在居高不下的剖腹產率中佔著重要的角色。
Abstract
Purpose: The aims of the study are to identify the influential factors on Cesarean section rate of newly immigrant women and the variations of perinatal outcomes and delivery modes between Taiwanese and newly immigrant women, and to explore out factors that affect the choice of delivery modes.
Materials and methods: From a population–base dataset from the Birth Registry of Taiwan on all births in 2004, 18,197 mothers born from Southeast Asia (SEA), 11603 from Mainland China (MC), and 189,392 from Taiwan (TW) were analyzed. Statistical differences among variables were compared by using analysis of variance (ANOVA) in combination with the Turkey HSD post hoc test and chi-square test. Odds ratios with 95% CIs for associations of maternal age and pregnancy outcomes with diabetes were estimated with logistic regression analyses. Computation was performed with SPSS software release 10.0.
Results: In the present study, significant differences of cesarean rates was observed among TW, MC and SEA (33.6%, 26.3% and 17.9%).TW mother is older than MC and SEA.(mean age:31.99, 30.84 and 27.13). The prenatal outcomes of mothers and newborns were all good in the 3 groups, but a relative higher premature delivery rate was observed in TW mothers (10.15%). In their choice of delivery place, most TW preferred in hospitals (68.68%), while South Asia mothers preferred clinics (43.80%). Statistical regression revealed that nationality(odd ratio:1,0.69,0.47) ,the age of mother more than 35 y/o (OR:1.09), excess or low birth weight (OR:2.77,1.82), lower Apgar score(less than 7)(OR:2.60) and delivery place in urban (OR:1.62) were the influential factors on the choice of cesarean section. There is no significant difference between hospital or clinics, but mothers delivery in South Taiwan have higher cesarean section rate than mid-Taiwan and north Taiwan. (OR:1.175)
Conclusion: After elimination of factors such as the age of mother, newborn birth weight and general health factors, we found the location of delivery is an important influential factor on cesarean rate. Furthermore, nationality is another important influential factor on the choice of cesarean section. This result revealed that different standards may exist in the treatment of immigrant mothers in the medical systems. We concluded that non-medical factors still play an important role on the choice of cesarean section in Taiwan. |
