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Migrants and obstetrics in Austria—applying a new questionnaire shows differences in obstetric care and outcome

Migration und Geburtshilfe in Österreich – die Anwendung eines neuen Fragebogens zeigt Unterschiede in Versorgung und Outcome auf

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Summary

Background

Immigration plays a major role in obstetrics in Austria, and about 18 % of the Austrian population are immigrants. Therefore, we aimed to (1) test the feasibility of a proposed questionnaire for assessment of migrant status in epidemiological research and (2) assess some important associations between procedures and outcomes in obstetrics and migration in selected departments in Austria.

Methods

We adapted a standardized questionnaire to the main immigration groups in Austria. Information on country of origin, length of residence in Austria and German-language ability was collected from eight selected obstetrics departments. Of the 1,971 questionnaires, 1,873 questionnaires of singleton births were selected and included in the analysis.

Results

We analyzed a total of 1,873 parturients with singleton births, of which 35 % had migrant status, 12 % were from ex-Yugoslavia, 12 % were from Turkey, and 12 % were from other countries. The proportion of parturients having their first care visit after the 12th week of pregnancy was higher in migrant groups (19 %). Smoking was highest in the migrants from ex-Yugoslavia (21 %). Vaginal delivery was more frequent in migrants from ex-Yugoslavia (78 %) and Turkey (83 %) than in nonmigrants (71 %) and episiotomy was more frequently performed in migrants from other countries. All differences are statistically significant.

Conclusions

Administration of a standardized questionnaire for assessment of migrant status in obstetric departments in Austria was shown to be feasible. We assessed differences in obstetric care and outcome and consequently recommend that action should be initiated in Austria toward harmonizing obstetric procedures among the migrant and the nonmigrant groups and toward minimizing risk factors.

Zusammenfassung

Grundlagen

Ungefähr 18 % der österreichischen Bevölkerung weisen einen Migrationshintergrund auf und Immigration nimmt auch in der Geburtshilfe einen immer größeren Stellenwert ein. Unsere Ziele waren es daher, 1) einen standardisierten Fragebogen für die Erfassung der Migrationshintergrundes in seiner Anwendbarkeit zu testen, und 2) Zusammenhänge zwischen Migrationshintergrund und der geburtshilflichen Versorgung und dem geburtshilflichem Outcome in ausgewählten Geburtenabteilungen in Österreich zu analysieren.

Methodik

Es wurde ein standardisierter Fragebogen eingesetzt, der neben Herkunftsland auch die Aufenthaltsdauer in Österreich sowie die Deutschkenntnisse abfragt. Der Fragebogen wurde auf alle Geburten im Zeitraum März bis Mai 2009 in acht ausgewählten Geburtenabteilungen in Österreich angewandt. In die Analyse wurden nur Einlingsgeburten aufgenommen.

Ergebnisse

Es konnten 1873 Fragebögen zu Einlingsgeburten analysiert werden, 35 % davon wiesen einen Migrationshintergrund auf (12 % aus Ex-Jugoslawien, 12 % aus der Türkei und 12 % aus anderen Ländern). Der Anteil der Frauen mit der ersten Schwangerschaftsuntersuchung nach der 12. Schwangerschaftswoche war bei Frauen mit Migrationshintergrund deutlich höher (19 vs. 9 %). Der Anteil der Frauen, die in der Schwangerschaft geraucht haben, war bei Migrationshintergrund Ex-Jugoslawien am höchsten mit 21 %. Bei Frauen mit Migrationshintergrund Ex-Jugoslawien und Türkei fanden mehr Vaginalgeburten statt (78 bzw. 83 %) verglichen mit Frauen ohne Migrationshintergrund (71 %). Alle Unterschiede waren statistisch signifikant.

Schlussfolgerungen

Der standardisierte Fragebogen für die Erhebung des Migrationshintergrundes war in der Geburtshilfe in Österreich gut anwendbar. Wir haben Unterschiede in der geburtshilflichen Versorgung und im geburtshilflichen Outcome bei Frauen mit Migrationshintergrund festgestellt und empfehlen daher Maßnahmen, diese Unterschiede auszugleichen, sowie Maßnahmen zur Reduzierung von Risikofaktoren, insbesondere Rauchen während der Schwangerschaft.

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Abbreviations

APR:

Austrian Perinatal Registry

BMI:

Body Mass Index

PW:

Pregnancy Week

CS:

Cesarean Section

EDA:

Epidural Anesthesia

SPA:

Spinal Anesthesia

SGA:

Small for Gestational Age

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Acknowledgments

We thank the midwives in the participating hospitals for their effort in filling in the standardized questionnaire, Patricia Gscheidlinger for the secretarial support and Mary Margreiter for native-speaker editing of the English.

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Authors and Affiliations

  1. Department of Clinical Epidemiology, Tyrolean State Hospitals Ltd., Innsbruck, Austria

    Willi Oberaigner,  Hermann Leitner &  Karin Oberaigner

  2. Department of Public Health and Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria

    Willi Oberaigner

  3. Department of Clinical Epidemiology, Tyrolean State HospitalsLtd, Innsbruck, Austria

    Willi Oberaigner

  4. Department of Obstetrics and Gynaecology, Reutte County Hospital, Reutte, Austria

    Gerald Pinzger

  5. Department of Obstetrics and Gynaecology, Bregenz State Hospital, Bregenz, Austria

    Hans Concin

  6. Department of Obstetrics and Gynaecology, Paracelsus Medical University, Salzburg, Austria

    Horst Steiner

  7. Department of Obstetrics and Gynaecology, Feldbach State Hospital, Feldbach, Austria

    Hannes Hofmann

  8. Department of Obstetrics and Gynaecology, Kaiser-Franz-Josef Hospital, SMZ-Süd, Vienna, Austria

    Teresa Wagner

  9. Department of Obstetrics and Gynaecology, Klagenfurt State Hospital, Klagenfurt, Austria

    Manfred Mörtl

  10. Department of Obstetrics and Gynaecology, Innsbruck Medical University Hospital, Innsbruck, Austria

    Christian Marth &  Angela Ramoni

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  1. Willi Oberaigner
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Correspondence to Willi Oberaigner.

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Oberaigner, W., Leitner, H., Oberaigner, K. et al. Migrants and obstetrics in Austria—applying a new questionnaire shows differences in obstetric care and outcome. Wien Klin Wochenschr 125, 34–40 (2013). https://doi.org/10.1007/s00508-012-0312-0

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  • DOI: https://doi.org/10.1007/s00508-012-0312-0

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