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Ethnic disparities in perinatal mortality at 40 and 41 weeks of gestation

  • Anita C.J. Ravelli EMAIL logo , Jelle M. Schaaf , Martine Eskes , Ameen Abu-Hanna , Esteriek de Miranda and Ben Willem J. Mol
Published/Copyright: January 11, 2013
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 41 Issue 4

Abstract

Objective: To evaluate whether maternal ethnicity affects perinatal mortality by week of gestation from 39 weeks onwards.

Study design: In this cohort study, we used data from the nationwide Netherlands Perinatal Registry from 1999 until 2008. All singleton infants born between 39+0 and 42+6 weeks of gestation without congenital anomalies were included. We used crude and multivariate logistic regression analyses with white Europeans as the reference to calculate the adjusted odds ratios (aOR) of South Asian, African and Mediterranean women. The main outcome measure was perinatal mortality (antepartum and intrapartum/neonatal mortality within 7 days after birth).

Results: We studied 1,092,255 singleton deliveries. Perinatal mortality occurred in 2315 infants (2.1‰). There was interaction between gestational age and ethnicity (P<0.0001). In week 40 (40+0–40+6) South Asian (aOR 1.9; 95% CI 1.1–3.4) and Mediterranean (aOR 1.3; 95% CI 1.04–1.7) women had an increased risk of perinatal mortality. The perinatal mortality risk became greater in week 41 for South Asian (aOR 4.5 95% CI 2.8–7.2), African (aOR 2.2; 95%CI 1.4–3.4) and Mediterranean (aOR 2.2; 95% CI 1.8–2.9) women, especially among small for gestational age infants.

Conclusion: With increasing gestational age beyond 39 weeks, perinatal mortality risk increases more strongly among South Asian, African and Mediterranean women compared to European whites.

Keywords: African continental ancestry group; ethnic groups; European continental ancestry group; fetal growth retardation; perinatal mortality; post-term; South Asian continental ancestry group; stillbirth; term birth
Corresponding author: Dr. Anita C.J. Ravelli, Academic Medical Center, Department of Medical Informatics, Room J1B-120, PO Box 22700, 1100 DE Amsterdam, The Netherlands

We thank all midwives, obstetricians and neonatologist in the Netherlands for data collection for the perinatal registry and the Netherland Perinatal Registry (www.perinatreg.nl) for giving permission for the study (11–85).

Conflict of interest statement

Contribution to authorship: AR, ME, JS and BW designed the study. AR performed the analyses and drafted the article. All of the authors contributed to the interpretation of the results and the revision of the text. All authors have approved the final version of the manuscript.

Details of ethics approval: The registry data are anonymous so no ethical approval was needed. The Netherlands Perinatal Registry has given permission for the analysis of its data.

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2012-9-21
Accepted: 2012-12-4
Published Online: 2013-01-11
Published in Print: 2013-07-01

©2013 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/jpm-2012-0228
Keywords for this article
African continental ancestry group; ethnic groups; European continental ancestry group; fetal growth retardation; perinatal mortality; post-term; South Asian continental ancestry group; stillbirth; term birth

Articles in the same Issue

  1. Masthead
  2. Masthead
  3. Review article
  4. Anxious and depressive components of Edinburgh Postnatal Depression Scale in maternal postpartum psychological problems1)
  5. Original Articles – Obstetrics
  6. Isolated low-normal amniotic fluid volume in the early third trimester: association with adverse perinatal outcomesa
  7. Trends in twin pregnancies and mode of delivery during the last 30 years: inconsistency between guidelines and clinical practice
  8. Prenatal care in adult women exposed to childhood sexual abuse
  9. Maternal and fetal adropin levels in gestational diabetes mellitus
  10. Ethnic disparities in perinatal mortality at 40 and 41 weeks of gestation
  11. Polymorphisms in the activin A receptor type 2A gene affect the onset time and severity of preeclampsia in the Turkish population
  12. Outcome of isolated fetal renal pyelectasis diagnosed during midtrimester screening ultrasound and cut-off value to predict a persistent or progressive pyelectasis in utero
  13. A polymorphism in an autophagy-related gene, ATG16L1, influences time to delivery in women with an unfavorable cervix who require labor induction
  14. Management of gestational hypertension – the impact of HYPITATa
  15. Reliability of quantitative elastography of the uterine cervix in at-term pregnancies
  16. Congenital anomalies, prematurity, and low birth weight rates in relation to nuclear power plant proximity1)
  17. Original Articles – Fetus
  18. Fetal magnetic resonance imaging of lymphangiomas
  19. Original Articles – Newborn
  20. Brainstem dysgenesis during the neonatal period: diagnosis and management
  21. Improving admission temperature in extremely low birth weight infants: a hospital-based multi-intervention quality improvement project
  22. Short Communication
  23. Periconceptional use of folic acid and risk of miscarriage – findings of the Oral Cleft Prevention Program in Brazil
  24. Congress Calendar
  25. Congress Calendar
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