Kleinräumige Analyse der Säuglingssterblichkeit in Bielefeld unter besonderer Berücksichtigung des Migrationshintergrundes, 2000–2006

Danke, Karen; Blecher, Christan; Bardehle, Doris; Cremer, David De; Razum, Oliver

doi:10.1055/s-0028-1100391

Cited by 4 publications

(4 citation statements)

References 2 publications

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“…Despite a positive trend in recent decades, there are indications that infant mortality among non-Germans is still higher than among Germans, [1]. Regional studies confirm this finding [24,25]. Women with Turkish origin and immigrant women with a short duration of stay seem to be mainly affected [1,25,26].…”

Section: Introductionmentioning

confidence: 99%

Stillbirth differences according to regions of origin: an analysis of the German perinatal database, 2004-2007

Reeske

Kutschmann

Razum

et al. 2011

BMC Pregnancy Childbirth

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BackgroundStillbirth 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.MethodsWe 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.ResultsA 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 relative risk of stillbirth for women from the Middle East/North Africa increased to 1.63 (95% CI 1.25-2.13). When adjusted for preterm births with low birthweight, women from Eastern Europe and the Middle East/North Africa experienced a 26% (43%) higher risk compared with women from Germany.ConclusionsWe found differences in risk of stillbirth among women from Middle East/North Africa, especially in association with low SES and low birthweight for gestational age. Our findings suggest a need for developing and evaluating socially and culturally sensitive health promotion and prevention programmes for this group. The findings should also stimulate discussion about the quality and appropriateness of antenatal and perinatal care of pregnant women and newborns with migrant backgrounds.

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Section: Introductionmentioning

confidence: 99%

Stillbirth differences according to regions of origin: an analysis of the German perinatal database, 2004-2007

Reeske

Kutschmann

Razum

et al. 2011

BMC Pregnancy Childbirth

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“…Der erh ö hte Anteil antepartaler Mortalit ä t in allen Migrantinnengruppen, insbesondere der antepartalen Mortalit ä t vor Klinikaufnahme, entspricht internationalen Ergebnissen [21] . Somit w ä re zu vermuten, dass in einigen F ä llen Fehlbildungen des Kindes erst sehr sp ä t oder gar nicht w ä hrend der Schwangerschaft entdeckt werden [3] . Der Anteil sp ä ter Vorsorgeuntersuchungen war in den Gruppen " T ü rkei " , " Ex-Jugoslawien / Osteuropa " und " andere L ä nder " doppelt so hoch wie in der Gruppe " Tirol / Ö sterreich " .…”

Section: Diskussion ▼unclassified

“…50 % am h ö chsten. Das Beispiel der M ü tter aus der Gruppe " T ü rkei " zeigt: ein niedriger sozial ö konomischer Status [3] , sprachliche Verst ä ndigungsschwierigkeiten und daraus resultierende geringere geburtshilfl ichen Operationsfrequenz [26] haben nicht den gleichen Einfl uss auf alle Migrantinnen. Unterschiede in der perinatalen Mortalit ä t, in der Inanspruchnahme von Vorsorgeuntersuchungen und im Risikoverhalten sind vorhanden.…”

Section: Diskussion ▼unclassified

“…Unterschiede im Outcome dieser Gruppen im Vergleich zur Tiroler Bev ö lkerung wurden untersucht. Das Herkunftsland der Mutter kann aus unterschiedlichen Gr ü nden, wie schlechterer sozio ö konomischer Status, sp ä te Vorsorgeuntersuchungen, Sprachprobleme und kulturelle Faktoren f ü r das outcome von Mutter und Kind pr ä gend sein: M ü tter werden im peripartalen Zeitraum als die ma ß geblich verantwortliche Person bez ü glich Gesundheit und Krankheit, Zugang zu Vorsorge und medizinischen Leistungen vor und w ä hrend der Schwangerschaft wahrgenommen [3] . Bei M ü ttern der zweiten und dritten Generation -mit dem Lebensmittelpunkt mehr als 20 Jahre in Tirol -kann davon ausgegangen werden, dass diese einen Akkulturationsprozess durchlaufen haben.…”

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Perinatale Mortalität nach Herkunftsland der Mutter in Tirol 2000–2008

Leitner¹,

Blüml²,

Oberaigner³

et al. 2011

Gesundheitswesen

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The good outcome of the mothers from "Turkey" can be seen as similar to the "Latina paradoxon", which means a better outcome of pregnancy and birth of mothers from "Turkey", even though they are more comparable with other migrant groups in some risk factors, such as a lower socioeconomic standard, late check-ups, language difficulties and cultural factors. A single case analysis would be necessary to examine the exact causes.

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