stillbirth differences according to regions of origin an analysis of the german perinatal database, 2004-2007原产地死胎根据地区差异的分析德国围产期数据库,2004 - 2007.pdf

Reeske et al. BMC Pregnancy and Childbirth 2011, 11:63 /1471-2393/11/63 RESEARCH ARTICLE Open Access Stillbirth differences according to regions of origin: an analysis of the German perinatal database, 2004-2007 1,2* 3 1 1,2 Anna Reeske , Marcus Kutschmann , Oliver Razum and Jacob Spallek Abstract Background: Stillbirth is a sensitive indicator for access to, and quality of health care and social services in a society. If a particular population group e.g. migrants experiences higher rates of stillbirth, this might be an indication of social deprivation or barriers to health care. This study examines differences in risk of stillbirth for women of different regions of origin compared to women from Germany in order to identify high risk groups/ target groups for prevention strategies. Methods: We used the BQS dataset routinely compiled to examine perinatal outcomes in Germany nationwide. Participation of hospitals and completeness of data has been about 98% in recent years. Data on all live births and stillbirths were obtained for the period 2004 to 2007 (N = 2,670,048). We calculated crude and stratified mortality rates as well as corresponding relative mortality risks. Results: A significantly elevated stillbirth rate was found for women from the Middle East and North Africa (incl. Turkey) (RR 1.34, CI 1.22-1.55). The risk was slightly attenuated for low SES. An elevated risk was also found for women from Asia (RR 1.18, CI 1.02-1.65) and from Mediterranean countries (RR 1.14, CI 0.93-1.28). No considerable differences either in use and timing of antenatal care or preterm birth and low birthweight were observed between migrant and non-migrant women. After stratification for light for gestational age, the relativ