Abstract
AIMS—To investigate the differences in perinatal death and child mortality between different ethnic groups in the Netherlands. METHODS—Retrospective analysis of data collected between 1990 and 1993 in the national obstetric registry comprising 569 743 births. Retrospective analysis of all death certificates of 0 to 15 year old children routinely collected between 1979 and 1993, comprising 20 211 deaths. RESULTS—Black mothers had the highest perinatal death rate compared with indigenous Dutch mothers (odds ratio 2.2). Hindustanis (West Indian Asians) had an odds ratio of 1.4 and Mediterraneans 1.3.The increased rate for black and Hindustani women could be fully explained by preterm birth. In the Mediterranean group the differences were explained by teenage pregnancy, grand multiparity, and socioeconomic status rather than prematurity. The death rate of Turkish and Moroccan children was twice as high as that of native Dutch children. For the different diagnostic categories this was: infectious diseases, relative risk (RR) 2.2; hereditary (metabolic) disorders, RR 2.0; accidents and drowning, RR 1.9. One quarter of the Turkish and Moroccan children died while on holiday in their country of origin. Sudden infant death syndrome was twice as high for Turkish infants as for Dutch children and four times higher than for Moroccan infants. CONCLUSION—Ethnic minorities in the Netherlands have a higher perinatal and child mortality rate than the indigenous Dutch. Apart from socioeconomic differences, sociocultural and lifestyle factors play an important role.
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- Aral S. O., Mosher W. D., Cates W., Jr Vaginal douching among women of reproductive age in the United States: 1988. Am J Public Health. 1992 Feb;82(2):210–214. doi: 10.2105/ajph.82.2.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Balarajan R., Soni Raleigh V., Botting B. Mortality from congenital malformations in England and Wales: variations by mother's country of birth. Arch Dis Child. 1989 Oct;64(10):1457–1462. doi: 10.1136/adc.64.10.1457. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Blackmore C. A., Savitz D. A., Edwards L. J., Harlow S. D., Bowes W. A., Jr Racial differences in the patterns of preterm delivery in central North Carolina, USA. Paediatr Perinat Epidemiol. 1995 Jul;9(3):281–295. doi: 10.1111/j.1365-3016.1995.tb00144.x. [DOI] [PubMed] [Google Scholar]
- Bundey S., Alam H., Kaur A., Mir S., Lancashire R. Why do UK-born Pakistani babies have high perinatal and neonatal mortality rates? Paediatr Perinat Epidemiol. 1991 Jan;5(1):101–114. doi: 10.1111/j.1365-3016.1991.tb00689.x. [DOI] [PubMed] [Google Scholar]
- Fiscella K. Racial disparities in preterm births. The role of urogenital infections. Public Health Rep. 1996 Mar-Apr;111(2):104–113. [PMC free article] [PubMed] [Google Scholar]
- Goldenberg R. L., Klebanoff M. A., Nugent R., Krohn M. A., Hillier S., Andrews W. W. Bacterial colonization of the vagina during pregnancy in four ethnic groups. Vaginal Infections and Prematurity Study Group. Am J Obstet Gynecol. 1996 May;174(5):1618–1621. doi: 10.1016/s0002-9378(96)70617-8. [DOI] [PubMed] [Google Scholar]
- Hillier S. L., Nugent R. P., Eschenbach D. A., Krohn M. A., Gibbs R. S., Martin D. H., Cotch M. F., Edelman R., Pastorek J. G., 2nd, Rao A. V. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. The Vaginal Infections and Prematurity Study Group. N Engl J Med. 1995 Dec 28;333(26):1737–1742. doi: 10.1056/NEJM199512283332604. [DOI] [PubMed] [Google Scholar]
- Llahi-Camp J. M., Rai R., Ison C., Regan L., Taylor-Robinson D. Association of bacterial vaginosis with a history of second trimester miscarriage. Hum Reprod. 1996 Jul;11(7):1575–1578. doi: 10.1093/oxfordjournals.humrep.a019440. [DOI] [PubMed] [Google Scholar]
- Moran J. S., Aral S. O., Jenkins W. C., Peterman T. A., Alexander E. R. The impact of sexually transmitted diseases on minority populations. Public Health Rep. 1989 Nov-Dec;104(6):560–565. [PMC free article] [PubMed] [Google Scholar]
- Ozalp I., Coskun T., Tokol S., Demircin G., Mönch E. Inherited metabolic disorders in Turkey. J Inherit Metab Dis. 1990;13(5):732–738. doi: 10.1007/BF01799576. [DOI] [PubMed] [Google Scholar]
- Parker J. D., Schoendorf K. C., Kiely J. L. Associations between measures of socioeconomic status and low birth weight, small for gestational age, and premature delivery in the United States. Ann Epidemiol. 1994 Jul;4(4):271–278. doi: 10.1016/1047-2797(94)90082-5. [DOI] [PubMed] [Google Scholar]
- Shiono P. H., Klebanoff M. A. Ethnic differences in preterm and very preterm delivery. Am J Public Health. 1986 Nov;76(11):1317–1321. doi: 10.2105/ajph.76.11.1317. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Singh G. K., Yu S. M. US childhood mortality, 1950 through 1993: Trends and socioeconomic diffferentials. Am J Public Health. 1996 Apr;86(4):505–512. doi: 10.2105/ajph.86.4.505. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tunçbílek E., Koc I. Consanguineous marriage in Turkey and its impact on fertility and mortality. Ann Hum Genet. 1994 Oct;58(Pt 4):321–329. doi: 10.1111/j.1469-1809.1994.tb00729.x. [DOI] [PubMed] [Google Scholar]
- van Enk A., Buitendijk S. E., van der Pal K. M., van Enk W. J., Schulpen T. W. Perinatal death in ethnic minorities in The Netherlands. J Epidemiol Community Health. 1998 Nov;52(11):735–739. doi: 10.1136/jech.52.11.735. [DOI] [PMC free article] [PubMed] [Google Scholar]
- van der Wal M. F., van Weert-Waltman M. L., Reijneveld S. A. Doodsoorzaken van in het buitenland overleden Amsterdamse kinderen, 1982-1993; mogelijkheden voor preventie. Ned Tijdschr Geneeskd. 1996 Apr 6;140(14):777–781. [PubMed] [Google Scholar]