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

Reeske A, Kutschmann M, Razum O, Spallek J. Stillbirth differences according to regions of origin: an analysis of the German perinatal database, 2004-2007. BMC Pregnancy and Childbirth. 2011;11(1): 63.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 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. Conclusions: We 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

Influences of ethnicity on perinatal and child mortality in the Netherlands

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.


Does the use of a foreign language influence attention and genre-specific viewing patterns for job advertisements? An eye-tracking study

The aim of this online experiment was to find evidence for both the alleged attention-getting function of the use of L2 English in job advertisements and for a possible genre–specific viewing pattern for job advertisements. A mixed design eye–track experiment among 30 native speakers of Dutch who saw all-Dutch and mixed Dutch– English job advertisements tested whether the use of foreign language English in Dutch ads changed the viewing pattern compared to all-Dutch job advertisements. That is, it investigated whether the use of a foreign language attracted more attention (in terms of first fixation, number and duration of fixations, and returned views), and altered the genre–specific viewing pattern for job ads. Overall, no evidence for the attention–getting ability of foreign language use in jobs ads was found. On the contrary, English used in the company information seemed to have a deterring effect. Support was found for a genre–specific viewing pattern for job ads, which, however, was not altered by the use of a foreign language. Our results suggest that use of English is not necessarily a good option to attract attention. Findings for genre-specific viewing patterns suggest that makers of job ads should make the job description as attractive as possible, since this is the first element viewed. This is the first online study to investigate the effect of language choice on attention in job ads and the viewing patterns specific to this ad genre

Enabling rules for advocacy in Kenya: Interim findings

Item does not contain fulltex