Ethnic disparities in perinatal mortality at 40 and 41 weeks of gestation

Ravelli, Anita C.J.; Schaaf, Jelle M.; Eskes, Martine; Abu‐Hanna, Ameen; Miranda, Esteriek de; Mol, Ben Willem J.

doi:10.1515/jpm-2012-0228

Cited by 13 publications

(16 citation statements)

References 22 publications

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“…Although the overall rate of caesarean sections reported by Washington et al . is much higher than in our cohort (20.8 versus 13.5%), we found the same trend in our data, namely that black women have a shorter mean duration of pregnancy, which has also been described in several previous articles . Similarly, a lower incidence of respiratory distress syndrome and earlier development of gross motor skills have been described in black neonates .…”

Section: Discussionsupporting

confidence: 88%

“…24 Although the overall rate of caesarean sections reported by Washington et al 25 is much higher than in our cohort (20.8 versus 13.5%), we found the same trend in our data, namely that black women have a shorter mean duration of pregnancy, which has also been described in several previous articles. 1,3,4,18,26 Similarly, a lower incidence of respiratory distress syndrome and earlier development of gross motor skills have been described in black neonates. 27,28 Although all confidence intervals crossed one in African-Caribbean women, there was a non-significant trend towards less adverse neonatal outcome with delivery from 38 weeks of gestation onwards, which is earlier than in white European women.…”

Section: Discussionmentioning

confidence: 89%

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Optimal timing of near‐term delivery in different ethnicities: a national cohort study

Kazemier

Ravelli

Groot

et al. 2014

BJOG

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Objective To study possible ethnic disparities in perinatal mortality and morbidity independent of the occurrence of pregnancy complications. In addition, to study the probabilities of adverse neonatal outcome for delivery, compared with 1 week of expectant management for each week of gestational age in the range of 36-42 weeks of gestation.Design National cohort study. [1999][2000][2001][2002][2003][2004][2005][2006][2007].Methods Numbers of antepartum and intrapartum/neonatal death, and neonatal morbidity, were expressed using the fetus/ neonate-at-risk approach. For each week of gestation, we compared the probability of adverse neonatal outcome (intrapartum/neonatal death in that week) for delivery with the probability of adverse neonatal outcome for expectant management (antepartum death in that week plus intrapartum/ neonatal death and morbidity in the subsequent week).Results Women of Mediterranean and African-Caribbean descent who were near term were at increased risk of antepartum and intrapartum/neonatal death, and neonatal morbidity, compared with white European women. Expectant management from 40 weeks of gestation onwards was associated with an increased probability of adverse neonatal outcome in white European women and in women of Mediterranean descent, compared with delivery (risk ratio, RR 1.45, 95% confidence interval, 95% CI 1.25-1.68, versus RR 1.69, 95% CI 1.11-2.60, and with number needed to deliver to prevent one adverse neonatal outcome being 563 and 364, respectively). This was not observed for women of African-Caribbean descent.Conclusions Ethnic disparities in perinatal outcomes were observed, with higher risks for women of Mediterranean descent. Expectant management in white European and Mediterranean women after 39 weeks of gestation is associated with an increased risk of adverse neonatal outcome.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 89%

Optimal timing of near‐term delivery in different ethnicities: a national cohort study

Kazemier

Ravelli

Groot

et al. 2014

BJOG

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“…labour dystocia (9-12% 25 versus 2-7% at term) and severe perineal injury related to 26 macrosomia (3.3% versus 2.6% at term) are increased in postterm 27 deliveries [6]. Furthermore, there is an increased risk of adverse 28 perinatal outcomes such as fetal death [6][7][8][9][10].…”

Section: Q2mentioning

confidence: 99%

Recurrence rate and outcome of postterm pregnancy, a national cohort study

Kortekaas

Kazemier

Ravelli

et al. 2015

European Journal of Obstetrics & Gynecology and Reproductiv

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“…As Warland et al [ 12 ] discuss in their recent publication, combinations of any of those risk factors with an acute stressor like venocaval compression may then lead to fetal demise. Also, a cluster of genetic predispositions correlated with ethnicity may influence the risk of stillbirth [ 13 , 14 ]. Infections are another cause of fetal death and severe neonatal morbidity [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Temporal trends in fetal mortality at and beyond term and induction of labor in Germany 2005–2012: data from German routine perinatal monitoring

Schwarz

Schäfers

Loytved

et al. 2015

Arch Gynecol Obstet

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PurposeWhile a variety of factors may play a role in fetal and neonatal deaths, postmaturity as a cause of stillbirth remains a topic of debate. It still is unclear, whether induction of labor at a particular gestational age may prevent fetal deaths.MethodsA multidisciplinary working group was granted access to the most recent set of relevant German routine perinatal data, comprising all 5,291,011 hospital births from 2005 to 2012. We analyzed correlations in rates of induction of labor (IOL), perinatal mortality (in particular stillbirths) at different gestational ages, and fetal morbidity. Correlations were tested with Pearson’s product-moment analysis (α = 5 %). All computations were performed with SPSS version 22.ResultsInduction rates rose significantly from 16.5 to 21.9 % (r = 0.98; p < 0.001). There were no significant changes in stillbirth rates (0.28–0.35 per 100 births; r = 0.045; p = 0.806). Stillbirth rates 2009–2012 remained stable in all gestational age groups irrespective of induction. Fetal morbidity (one or more ICD-10 codes) rose significantly during 2005–2012. This was true for both children with (from 33 to 37 %, r = 0.784, p < 0.001) and without (from 25 to 31 %, (r = 0.920, p < 0.001) IOL.ConclusionsAn increase in IOL at term is not associated with a decline in perinatal mortality. Perinatal morbidity increased with and without indiction of labor.

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Ethnic disparities in perinatal mortality at 40 and 41 weeks of gestation

Abstract: With increasing gestational age beyond 39 weeks, perinatal mortality risk increases more strongly among South Asian, African and Mediterranean women compared to European whites.

Cited by 13 publications

References 22 publications

Optimal timing of near‐term delivery in different ethnicities: a national cohort study

Optimal timing of near‐term delivery in different ethnicities: a national cohort study

Recurrence rate and outcome of postterm pregnancy, a national cohort study

Temporal trends in fetal mortality at and beyond term and induction of labor in Germany 2005–2012: data from German routine perinatal monitoring

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