Resultados materno-perinatales de gestantes peruanas en Chile: Exploración del efecto del migrante sano / Maternal and perinatal outcomes of peruvian pregnant women in Chile: exploring the healthy immigrant effect

RESUMEN

RESUMEN Objetivos: Comparar indicadores materno-perinatales entre gestantes chilenas y peruanas en Santiago de Chile entre enero y julio del 2017. Materiales y métodos: Estudio transversal analítico en 1578 chilenas y 318 peruanas atendidas en un hospital clínico de Santiago. Se realizó un análisis comparativo de las variables materno-perinatales por nacionalidad. Se realizaron modelos logísticos crudos y ajustados con sus intervalos de confianza al 95% (IC 95%). Resultados: Las gestantes peruanas residían en promedio 5,7 años en Chile, tenían más edad (28,1 ± 6,5 vs. 26,6 ± 6,5 años), menos desocupación (52,3% vs. 60,6%), más probabilidad de ingreso tardío al control prenatal (CP) (OR 2,17, IC 95% 1,69-2,78) y de tener anemia (OR 3,45, IC 95% 2,13-5,56) asociada al ingreso tardío a CP (OR ajustado 0,43, IC95% 0,33-0,56). Las gestantes chilenas tuvieron una mayor probabilidad de obesidad al ingreso al CP (OR 2,48 IC 95% 1,81-3,41) y al parto (OR 2,03, 1,57-2,62). Así como, de diabetes gestacional (DG) (OR 2,12, IC 95% 1,24-3,61), parto prematuro (OR 2,82, IC 95% 1,59-5,01) e hijos con bajo peso al nacer (BPN) (OR 3,10, IC 95% 1,51-6,33). En el modelo ajustado la obesidad se asoció en forma independiente a la DG (OR ajustado 3,8, IC 95% 2,44-6,18) y al BPN (OR ajustado 3,34, IC95% 2,33-4,85. Conclusiones: El efecto del migrante sano se observa en gestantes inmigrantes peruanas, principalmente en resultados perinatales. Es necesario favorecer el ingreso precoz a la atención prenatal, prevenir la anemia y la obesidad, para evitar resultados materno-perinatales adversos en esta población.

ABSTRACT

ABSTRACT Objectives: To compare maternal and perinatal outcomes between Chilean and Peruvian pregnant women in Santiago, Chile, between January and July 2017. Materials and methods: Analytical cross-sectional study of 1,578 Chilean and 318 Peruvian women who attended a clinical hospital in Santiago. We conducted a comparative analysis of maternal and perinatal variables by nationality. Crude and adjusted logistic models were carried out with a 95% confidence interval (95% CI). Results: Peruvian pregnant women resided an average of 5.7 years in Chile, were older (28.1 ± 6.5 vs. 26.6 ± 6.5 years), had less unemployment (52.3% vs. 60.6%), were more likely to enter prenatal care (PC) late (OR 2.17, 95% CI 1.69-2.78) and had higher probability of having anemia (OR 3.45, 95% CI 2.13-5.56) associated with late entry to PC (adjusted OR 0.43, 95% CI 0.33-0.56). On the other hand, Chilean pregnant women were more likely to be obese upon entry to PC (OR 2.48, 95% CI 1.81-3.41) and at the time of delivery (OR 2.03, 95% CI 1.57-2.62). In addition, Chilean women had higher rates of gestational diabetes (GD) (OR 2.12, 95% CI 1.24-3.61), premature delivery (OR 2.82, 95% CI 1.59-5.01) and low birth weight (LBW) (OR 3.10, 95% CI 1.51-6.33). In the adjusted model, obesity was independently associated with GD (adjusted OR 3.8, 95% CI 2.44-6.18) and LBW (adjusted OR 3.34, 95% CI 2.33-4.85). Conclusions: The healthy immigrant effect was observed in pregnant Peruvian immigrants, mainly regarding the perinatal outcomes. It is necessary to promote early access to prenatal care and to stablish measures to prevent anemia and obesity, in order to avoid adverse maternal and perinatal outcomes in the studied population.