Abstract:
INTRODUCTION:Short and long interpregnancy intervals are associated with adverse perinatal outcomes such as miscarriage and preterm delivery, but cultural differences in interpregnancy intervals are understudied. Identifying cultural inequality in interpregnancy intervals is necessary to improve maternal-child outcomes. We assessed interpregnancy intervals for Anglophones and Francophones in Quebec. METHODS:We obtained birth records for all infants born in Quebec, 1989-2011. We identified 571 461 women with at least two births, and determined the interpregnancy interval. We defined short interpregnancy intervals (< 18 months) as the 20th percentile of the distribution, and long intervals (≥ 60 months) as the 80th percentile. Using quantile regression, we evaluated the association of language with short and long intervals, adjusted for maternal characteristics. We assessed differences over time and by maternal age for disadvantaged groups defined as no high school diploma, rural residence, and material deprivation. RESULTS:In adjusted regression models, Anglophones who had no high school diploma had intervals that were 1.0 month (95% CI: -1.5 to -0.4) shorter than Francophones at the 20th percentile of the distribution, and 1.9 months (-0.5 to 4.3) longer at the 80th percentile. Results were similar for Anglophones in rural and materially deprived areas. The trends persisted over time, but were stronger for women < 30 years. There were no differences between advantaged Anglophones and Francophones. CONCLUSION:Disadvantaged Anglophones are more likely to have short and long interpregnancy intervals relative to Francophones in Quebec. Public health interventions to improve perinatal health should target suboptimal intervals among disadvantaged Anglophones. INTRODUCTION:On sait que les intervalles courts comme les intervalles longs entre les grossesses sont associés à des issues périnatales défavorables, comme des fausses couches et des accouchements prématurés, mais les différences culturelles à ce sujet sont mal connues. Repérer les inégalités culturelles dans les intervalles entre les grossesses est nécessaire afin d'améliorer les résultats relatifs à la santé de la mère et de l’enfant. Nous avons ainsi évalué les intervalles entre les grossesses chez les anglophones et les francophones du Québec. MÉTHODOLOGIE:Nous avons obtenu les dossiers de naissance de tous les enfants nés au Québec entre 1989 et 2011. Nous avons recensé 571 461 femmes ayant eu au moins deux naissances et déterminé l’intervalle entre leurs grossesses. Les intervalles courts entre les grossesses (moins de 18 mois) ont été définis comme étant le 20e percentile de la distribution, et les intervalles longs (60 mois ou plus), comme le 80e percentile. À l’aide de régressions quantiles, nous avons évalué l’association entre la langue et les intervalles courts et longs, ajustés en fonction des caractéristiques de la mère. Nous avons évalué les différences au fil du temps et selon l’âge de la mère pour les groupes défavorisés, qui ont été définis par l’absence de diplôme d’études secondaires, la résidence en milieu rural et le fait de vivre dans un quartier défavorisé matériellement. RÉSULTATS:Dans les modèles de régression ajustés, les anglophones sans diplôme d’études secondaires avaient des intervalles plus courts de 1,0 mois (intervalle de confiance [IC] à 95 % : −1,5 à −0,4) par rapport à leurs homologues francophones au 20e percentile de la distribution et plus longs de 1,9 mois (−0,5 à 4,3) au 80e percentile. Les résultats étaient similaires pour les anglophones des régions rurales et des quartiers matériellement défavorisés. Les tendances se sont maintenues au fil du temps, et se sont révélées plus fortes chez les femmes de moins de 30 ans. Aucune différence n’a été relevée entre les francophones favorisées et les anglophones favorisées. CONCLUSION:Au Québec, les anglophones défavorisées étaient plus susceptibles d’avoir des intervalles courts ou des longs entre leurs grossesses que les francophones défavorisées. Les interventions de santé publique visant à améliorer la santé périnatale devraient donc cibler les intervalles sous-optimaux chez les anglophones défavorisées de la province.
journal_name
Health Promot Chronic Dis Prev Canjournal_title
Health promotion and chronic disease prevention in Canada : research, policy and practiceauthors
Auger N,Lemieux L,Bilodeau-Bertrand M,Barry AD,Costopoulos Adoi
10.24095/hpcdp.38.5.02subject
Has Abstractpub_date
2018-05-01 00:00:00pages
201-209issue
5issn
2368-738Xjournal_volume
38pub_type
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