Title | Maternal deaths among rural-urban migrants in China: a case-control study |
Authors | Zhang, Jingxu Zhang, Xiaozhuang Qiu, Liqian Zhang, Ronglian Hipgrave, David B. Wang, Yan Zhang, Pei Pang, Ruyan Guo, Sufang |
Affiliation | Peking Univ, Hlth Sci Ctr, Sch Publ Hlth, Dept Child Adolescent & Womens Hlth, Beijing 100191, Peoples R China. Guangdong Womens & Children Hosp, Guangzhou 510010, Guangdong, Peoples R China. Zhejiang Univ, Sch Med, Womens Hosp, Hangzhou 310006, Zhejiang, Peoples R China. Fujian Prov Matern & Child Hlth Hosp, Fuzhou 350001, Fujian, Peoples R China. UNICEF, New York, NY 10017 USA. Maternal & Children Hlth Assoc China, Beijing 100080, Peoples R China. UNICEF Off China, Beijing 100600, Peoples R China. Maternal & Children Hlth Assoc China, Wanquanhe Lu Xiaonanzhuang 400, Beijing 100080, Peoples R China. |
Keywords | Maternal mortality Associations Risk factors Rural-urban migrant women Systematic management China MORTALITY HEALTH PREDICTORS SERVICES SHANGHAI WORKERS TRENDS WOMEN |
Issue Date | 2014 |
Publisher | bmc public health |
Citation | BMC PUBLIC HEALTH.2014,14. |
Abstract | Background: Disparity in maternal mortality exists between rural-urban migrant and urban resident women in China, but little research has provided evidence for related policy development. The objective of this study was to identify associations with and risks for maternal death among rural-urban migrant women in order to improve health services for migrant women and reduce maternal mortality in China. Methods: We conducted a prospective case-control study in urban areas of Guangdong, Zhejiang and Fujian provinces and Beijing municipality. In each, migrant women who died between July 1, 2010 and October 1, 2011 were identified through reports from China's Maternal and Child Mortality Surveillance System. For each, four matched controls were selected from migrant women who delivered in local hospitals during the same period. We compared socio-demographic characteristics, health status and health service variables between cases and controls, and used bivariate and multivariate conditional logistic regression analyses to determine associations with and risk factors for maternal death. Results: 109 cases and 436 controls were assessed. Family income <2000 yuan per month (OR = 4.5; 95% CI 1.7-11.7) and lack of health insurance (OR = 1.3; 95% CI 1.1-1.6) were more common amongst women who died, as were lack of antenatal care (ANC) (OR = 22.3; 95% CI 4.3-116.0) and attending ANC only 1-4 times (OR = 5.0; 95% CI 1.6-15.5). Knowledge of danger signs during delivery was less common in this group (OR = 0.3; 95% CI 0.1-0.8). Conclusion: Differences existed between migrant women who died in pregnancy and surviving controls. The identified risk factors suggest strategies for health sector and community action on reducing maternal mortality among migrant women in China. A systematic approach to maternity care for rural-urban migrant women is recommended. |
URI | http://hdl.handle.net/20.500.11897/214325 |
ISSN | 1471-2458 |
DOI | 10.1186/1471-2458-14-512 |
Indexed | SCI(E) SSCI |
Appears in Collections: | 公共卫生学院 |