International Union for Circumpolar Health Ministry of Public Health and Social Development of RF Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Sciences Medical Polar Fund “Science” The Northern Forum

Abstracts

Ethnic peculiarities of the North native inhabitants health

Objectives: The Centers for Disease Control (CDC) and the Indian Health Service (IHS) determined that there was little published information specific to maternal morbidity among American Indian and Alaska Natives.

Study Design: Retrospective aggregated maternal morbidity data from the National Patient Information Reporting System (NPIRS) for 2002-2004 for five IHS health care facilities was analyzed by individuals at the CDC and IHS.

Methods: We analyzed the maternal morbidity data for Alaska Native Medical Center (ANMC) to compare maternal morbidities to the aggregate of five other IHS facilities. Maternal morbidity data for ANMC for the years 2002-2004 was analyzed using SAS 9.1. Morbidities were classified using ICD-9 codes into 6 main categories with seven subcategories.

Results: 69% of the 1979 AI/AN women did not have any maternal morbidities. 2 % had an antenatal hemorrhage, 7% had a postpartum hemorrhage, 2% had transient hypertension, 9% had some form of preeclampsia / eclampsia, 13% had an infection and 5% had gestational diabetes. Among women who had a cesarean delivery, women who had other infections had the longest average hospital stay of 6.8 days. Among women who did not have a cesarean delivery, women who had severe preeclampsia /eclampsia had the longest average hospital stay of 4.3 days. These women also had a lower prevalence of postpartum hemorrhage, transient hypertension, amniotic infection, fever, DVT/obstetric embolism, and gestational diabetes. When comparing the ANMC data to the aggregate data, all of the prevalence rates of maternal morbidities were significantly different from each other (p<.05), except for genitourinary infection. The differences between average length of hospital stay for women with other infections (cesarean delivery) and severe preeclampsia /eclampsia (non-cesarean delivery) were not statistically significant (p<.05).

Conclusion: ANMC have longer hospital stays in general, a lower percentage of cesarean deliveries, higher utilization of mid-wifery services, a higher prevalence of preeclampsia /eclampsia, “other” infections, and slightly higher prevalence rates of antenatal hemorrhage and genitourinary infection. ANMC should consider programmatic changes to meet these challenges.

Note. Abstracts are published in author's edition

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Last update: 06-Jul-2012 (11:52:05)