Article
Influences of ethnicity on perinatal and child mortality in the
Netherlands
T W J Schulpen, J E van Steenbergen, H F van Driel
Wilhelmina
Children's Hospital, Huispost KE 04-153.0, Postbus 85090, 3508 AB
Utrecht, Netherlands
Correspondence to: Prof. Schulpen t.schulpen{at}wkz.azu.nl
Accepted 19 October
2000
AIMS
To investigate the differences
in perinatal death and child mortality between different ethnic groups
in the Netherlands.
METHODSRetrospective 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.
RESULTSBlack 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.
CONCLUSIONEthnic 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.
Keywords: death; mortality; sudden infant death syndrome; ethnic group; Netherlands; social environment
© 2001 by Archives of Disease in Childhood
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