BMC Public Health
Volume 14, Issue 1, 2014

Maternal deaths among rural-urban migrants in China: A case-control study (Article) (Open Access)

Zhang J. , Zhang X. , Qiu L. , Zhang R. , Hipgrave D.B. , Wang Y. , Zhang P. , Pang R.* , Guo S.
  • a Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Beijing, Haidian District 100191, China
  • b Guangdong Women's and Children Hospital, Guangyuanxi Lu 13, Yuexiu District, Guangzhou, Guangdong 510010, China
  • c Women's Hospital, School of Medicine, Zhejiang University, Xueshi Lu 1, Hangzhou, Zhejiang 310006, China
  • d Fujian Provincial Maternity and Child Health Hospital, Daoshan Lu 18, Gulou District, Fuzhou, Fujian 350001, China
  • e UNICEF, 3 UN Plaza, NY 10017, United States
  • f Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Beijing, Haidian District 100191, China
  • g Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Beijing, Haidian District 100191, China
  • h Maternal and Children Health Association of China, Wanquanhe Lu Xiaonanzhuang 400, Beijing, Haidian Diastrict 100080, China
  • i UNICEF Office for China, 12 Sanlitun Lu, Beijing, 100600, China

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. © 2014 Zhang et al.; licensee BioMed Central Ltd.

Author Keywords

Systematic management China Maternal mortality Rural-urban migrant women Associations risk factors

Index Keywords

urban population China prospective study pregnancy complication Pregnancy Complications Prospective Studies human epidemiology statistics and numerical data rural population health service Humans female maternal death pregnancy adult migration maternal mortality Case-Control Studies Transients and Migrants Maternal Health Services case control study mortality
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84902377717&doi=10.1186%2f1471-2458-14-512&partnerID=40&md5=24041f1519a1094137189c8808e3cb81
DOI: 10.1186/1471-2458-14-512
ISSN: 14712458
Cited by: 3
Original Language: English