Obstetric outcome of Bangladeshi women in East London

Abstract

Objective To study the obstetric outcome of women of Bangladeshi origin in comparison with the white Caucasian population in East London. Design A retrospective study of 16718 pregnancies over a five year period (1987–1991). Setting An East London teaching hospital district. Subjects Six thousand four hundred and sixty Bangladeshi women compared with 7592 white Caucasian women. Main outcome measures Maternal: antenatal complications; induction and augmentation rates; analgesia and anaesthesia; instrumental delivery and caesarean section rates; third stage complications. Fetal: gestation and weight at birth; perinatal mortality rates. Results The following statistically significant findings were noted: Bangladeshi women had a longer reproductive age span and were of greater parity including grand multiparity. They suffered fewer antenatal complications except for gestational diabetes. They had lower induction rates and, among the parous group, lower augmentation rates. During labour they required less analgesia but more commonly had general anaesthesia for caesarean section deliveries. They required instrumental delivery less often but there was no difference in overall caesarean section rate for the two groups. However, overall Bangladeshi women had a lower elective caesarean section rate, although parous Bangladeshi women had a higher emergency section rate. In the third stage there were no differences in the complication rates for the nulliparous women, however the parous Bangladeshi women had a higher postpartum haemorrhage rate and a lower perineal repair rate consistent with their higher parity. Whilst preterm births were more common in Bangladeshi women, significant prematurity (less than 28 weeks gestation) was less common. Similarly, although Bangladeshi babies weighed less at birth, they had fewer babies weighing less than 1500 grammes. There was no statistically significant difference in the perinatal mortality rate between the two groups, being 8.1 per thousand births overall. Whilst there was a statistically insignificant decline in death rates over the five‐year period, between the groups there was no consistent difference. Conclusion Pregnant Bangladeshi women in East London constitute a relatively high parity, low risk population who have less obstetric intervention and yet manage an equivalent (or better) perinatal outcome compared to their white Caucasian neighbours.

Stillbirths and infant deaths among migrants in industrialized countries

“…All reviewed studies are presented in Table I (2–44). Of the 42 initial reports related to stillbirths and infant mortality, eight were excluded: one had only the abstract available (10), one did not present mortality rates (14), two papers presented results of data already included in the review in two other reports (20 vs. 23; 4 vs. 38), one presented mortality rates for diabetics only (41) one reported no stillbirths or infant deaths among migrants or their control group (27), and two referred only to spontaneous abortions, not stillbirths, and their usefulness was limited for our analysis (30), (37).…”

“…The definition of stillbirth varied between the studies (16, 20, 22 and 28 weeks of gestations), and this information was also missing from some studies. In total, 18 studies reported mortality for singletons only (5, 8, 10–13, 18, 19, 20/23, 25, 26, 28, 29, 33, 34, 39, 43, 44), 11 included both singletons and multiple births (2, 9), (14), (21), (24), (34), (36), (38), (40–42), one study included non‐malformed singletons only (44), and one had separate analyses for all newborns and singletons (17). For the remaining studies, it remained unclear whether all newborns were included or singletons only.…”

“…Non‐refugee migrants have family‐, education‐ and work‐related reasons for their migration, but this information is seldom gathered in routine data collections or even investigated in specific studies. In the European studies, all non‐refugee migrants – who were neither registered refugees nor originating from refugee source countries – had higher crude stillbirth rates (RR = 1.40 (95% CI 1.22, 1.58)) (2, 14), (50), (13), (17), (31), perinatal mortality rates (RR = 1.35 (95% CI 1.26, 1.45)) (2, 13), (17), (25), (27), (33), (39), (42), neonatal mortality rates (RR = 1.34 (95% CI 1.30, 1.38)) (7, 8), (11), (31), (38) and infant mortality rates (RR = 1.33 (95% CI 1.30, 1.36)) (2, 11), (31), (38).…”

Bacteriuria in pregnancy: A comparison of Bangladeshi and Caucasian women

“…Furthermore, certain ethnic groups are thought to have a greater predisposition to urinary tract infections [11,[15][16][17]. Our earlier report on pregnancy outcomes [18] suggested that the predisposition of Bangladeshi women to bacteriuria during pregnancy was surprisingly less than for their Caucasian neighbors. With this in mind, we sought to determine whether the rate of bacteriuria during pregnancy differed among Caucasian women compared to Bangladeshi women, irrespective of age and parity.…”

The effect of migration background on obstetric performance in Switzerland

“…European studies on gestational length and birth weight have given discrepant results. While some found no differences 1,4-6 , others revealed a higher incidence of preterm delivery and low birth weight in specific immigrant groups 3,[8][9][10][11] .…”