Perinatal and Infant Health Outcomes among Neonates Born to Aboriginal Parents in Taiwan

台灣原住民新生兒的周產期與嬰兒期健康預後之探討

張宇勳(Yu-Hsun Chang) ； 陳保中(Pau-Chung Chen) ； 謝佳容(Chia-Jung Hsieh) ； 鄭素芳(Suh-Fang Jeng) ； 廖華芳(Hua-Fang Liao) ； 蘇怡寧(Yi-Ning Su) ； 林秀娟(Shio-Jean Lin) ； 周弘傑(Hung-Chieh Chou) ； 林宜平(Yi-Ping Lin) ； 謝武勳(Wu-Shiun Hsieh)

《Acta Paediatrica Taiwanica》 48卷3期 (2007/06) Pp. 135-140

https://doi.org/10.7097/APT.200706.0135

摘要

背景：國外的研究顯示原住民新生兒具較差的健康情形。本研究的目的在探討台灣地區全國性非原住民與原住民新生兒的活產情形、不良出生預後、以及嬰兒期依年齡別之死亡率的特色。
方法：本研究收集了從2000年至2003年台灣地區所有活產的新生兒，針對他們發生不良生產預後，如：低出生體重、早產與出生體重相對不足(SGA)的分佈狀況以及嬰兒期依年齡別之死亡率加以分析。我們使用統計學方法來評估因父母各別種族之不同探討其新生兒之周產期與嬰兒期的健康預後情形。
結果：在所收集的947,317個樣本中，母親為原住民的有9,381位，父親為原住民的有6,429位，而父母皆為原住民的有15,354位。生下低出生體重兒、早產兒與出生體重相對不足的風險，依：父母皆非原住民、母親為原住民、父親為原住民、父母皆為原住民的分組評估而呈現逐漸升高的現象。此外，早期新生兒死亡率、新生兒死亡率以及嬰兒死亡率皆有類似逐漸升高傾向。若依居住地區之分佈來評估，即使依居住地區之因素加以校正，此種傾向依然存在；若雙親均為原住民而且居住在鄉鎮地區或山區，則其所生的小孩發生不良出生預後之風險與嬰兒期的死亡率更為居高。
結論：新生兒之雙親為原住民與其所居住地區是造成臺灣地區新生兒期與嬰兒期健康預後不佳的重要相關因素。

關鍵字

周產期預後 ； 嬰兒期預後 ； 原住民

並列摘要

Background: Poor health outcomes among neonates born to aborigines has been reported in many countries. This study was aimed to examine the nationwide characteristics of live births, adverse birth outcomes, and age-specific mortality among neonates born to non-aboriginal and aboriginal parents in Taiwan.
Methods: All neonates born alive during the period of 2000 to 2003 in Taiwan were included. The adverse birth outcomes including low birth weight, preterm, and small-for-gestational-age births, and age-specific mortality were obtained. Logistic regression analysis was used to estimate odds ratios for parental ethnicity in relation to birth outcomes, while Cox's proportional hazards regression models were used to estimate hazard ratios for parental ethnicity in relation to age-specific infant deaths.
Results: A total of 947,317 live births were included that consisted of 9,381 born t o aboriginal mothers, 6,429 born to aboriginal fathers, and 15,354 born to aboriginal parents. There was a gradual increase in the risk of having a baby with low birth weight, preterm, or small for gestational age born to the four parental aboriginal ethnicity groups: non-aboriginal parents, aboriginal mother only, aboriginal father only, and aboriginal parents. Similar trends were also found for early neonatal, neonatal, and infant mortalities after stratification of residential areas. The neonates born to both aboriginal parents with residence in rural or mountain areas were at highest risk of adverse birth outcomes and age-specific mortality.
Conclusions: Our results demonstrated that aboriginality and residential area are important risk factors for adverse perinatal and infant outcomes.

並列關鍵字

perinatal outcome ； infant outcome ； aborigines