Maternal care and birth outcomes among ethnic minority women in Finland

<p>Abstract</p> <p>Background</p> <p>Care during pregnancy and labour is of great importance in every culture. Studies show that people of migrant origin have barriers to obtaining accessible and good quality care compared to people in the host society. The aim of this study is to compare the access to and use of maternity services, and their outcomes among ethnic minority women having a singleton birth in Finland.</p> <p>Methods</p> <p>The study is based on data from the Finnish Medical Birth Register in 1999–2001 linked with the information of Statistics Finland on woman's country of birth, citizenship and mother tongue. Our study data included 6,532 women of foreign origin (3.9% of all singletons) giving singleton birth in Finland during 1999–2001 (compared to 158,469 Finnish origin singletons).</p> <p>Results</p> <p>Most women have migrated during the last fifteen years, mainly from Russia, Baltic countries, Somalia and East Europe. Migrant origin women participated substantially in prenatal care. Interventions performed or needed during pregnancy and childbirth varied between ethnic groups. Women of African and Somali origin had most health problems resulted in the highest perinatal mortality rates. Women from East Europe, the Middle East, North Africa and Somalia had a significant risk of low birth weight and small for gestational age newborns. Most premature newborns were found among women from the Middle East, North Africa and South Asia. Primiparous women from Africa, Somalia and Latin America and Caribbean had most caesarean sections while newborns of Latin American origin had more interventions after birth.</p> <p>Conclusion</p> <p>Despite good general coverage of maternal care among migrant origin women, there were clear variations in the type of treatment given to them or needed by them. African origin women had the most health problems during pregnancy and childbirth and the worst perinatal outcomes indicating the urgent need of targeted preventive and special care. These study results do not confirm either healthy migrant effect or epidemiological paradox according to which migrant origin women have considerable good birth outcomes.</p

The effectiveness of web‐based mobile health interventions in pediatric outpatient surgery:a systematic review and meta‐analysis of randomized controlled trials

Abstract Aims: To evaluate the effectiveness of web‐based mobile health interventions on pediatric patients and their parents in the day surgery context, where the primary outcome was children’s preoperative anxiety and secondary outcomes were postoperative pain and parents’ anxiety and satisfaction with entire course of the day surgery. Design: A systematic review and meta‐analysis of randomized controlled trials. Data Sources: CENTRAL, CINAHL, Scopus, Ovid MEDLINE and Web of Science were systematically searched without time limits (up to December 2018). Review Methods: Studies were appraised using the Cochrane risk of bias tool. A random effect meta‐analysis of children’s preoperative anxiety was performed. Results: Eight studies with a total of 722 patients were included in the analysis. The effectiveness of web‐based mobile health interventions, including age‐appropriate videos, web‐based game apps and educational preparation games made for the hospital environment, was examined in preoperative settings. A meta‐analysis (N=560 children) based on six studies found a statistically significant reduction in preoperative anxiety measured by the Modified Yale Preoperative Anxiety Scale with a moderate effect size. Three studies reported parental satisfaction. Conclusions: Web‐based mobile health interventions can reduce children’s preoperative anxiety and increase parental satisfaction. Web‐based mobile health interventions could be considered as nonpharmacological distraction tools for children in nursing. There is not enough evidence regarding the effectiveness of reducing children’s postoperative pain and parental anxiety using similar interventions. Impact: Web‐based mobile health interventions reduce children´s preoperative anxiety and could therefore be considered as non‐pharmacological distraction tools for children in nursing