Title
Perinatal death in ethnic minorities in the Netherlands
Author
van Enk, A.
Buitendijk, S.E.
van der Pal, K.M.
van Enk, W.J.J.
Schulpen, T.W.J.
TNO Preventie en Gezondheid
Publication year
1998
Abstract
Objectives - To investigate differences in perinatal death rate and associated obstetric risk factors between ethnic groups in the Netherlands. Design - Retrospective cohort study based on the 1990-1993 birth cohorts in the National Obstetric Registry. Subjects - 569,743 births of which 85,527 were for women belonging to ethnic minorities. Main outcome measures - Perinatal death occurring between 16th week of pregnancy and 24 hours after birth. Method - Bivariate and multivariate analysis of perinatal death rate per ethnic group. A total of 42,282 women living in the three main cities of the Netherlands were classified on the basis of postal code districts into four socioeconomic (SES) classes for analysis of the relation between SES, perinatal death, and preterm birth. Results - Black mothers had the highest perinatal death rate compared with indigenous Dutch (odds ratio 2.2, 95%CI 1.9, 2.4) followed by a group 'others', consisting of women of mixed or unknown ethnicity (odds ratio 1.8, 95%CI 1.5, 2.0), Hindustani (odds ratio 1.4, 95%CI 1.2, 1.6), and Mediterraneans (odds ratio 1.3, 95%CI 1.2, 1.4). Asians (excluding West Indian Asians) and non-Dutch Europeans did not have higher rates than Dutch women. The increased rates of black and Hindustani women could be explained fully and that of the group 'others' partially by higher rates of preterm birth. Controlling for age and parity lowered the odds ratio of the Mediterraneans slightly. The risk of ethnicity was independent of SES. Conclusion - Ethnic minorities in the Netherlands except immigrants from Asia and other European countries have higher rates of perinatal death than indigenous Dutch women. With a twofold increase, black women had the highest rate, which was related to an equally large increased rate of preterm birth.
Subject
Health
Adolescent
Adult
Cohort Studies
Ethnic Groups
Female
Humans
Infant Mortality
Infant, Newborn
Infant, Premature
Logistic Models
Middle Aged
Netherlands
Pregnancy
Retrospective Studies
Risk Factors
Social Class
Netherlands
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DOI
https://doi.org/10.1136/jech.52.11.735
TNO identifier
234664
ISSN
0143-005X
Source
Journal of Epidemiology and Community Health, 52 (11), 735-739
Document type
article