Comparison of stillbirth rates by cause among Haitians and non-Haitians in Canada

详细信息    查看全文

• 作者：Nathalie Auger^a ; ^b ; ^{nathalie.auger@inspq.qc.ca" class="auth_mail" title="E-mail the corresponding author} ; André ; Costopoulos^c ; Ashley I. Naimi^d ; Fulvia Bellingeri^a ; ^b ; Lé ; a Vecchiato^e ; William D. Fraser^f
• 关键词：Emergencies ; Placental abruption ; Pregnancy complications ; Stillbirth ; Vulnerable populations
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：134
• 期：3
• 页码：315-319
• 全文大小：419 K

文摘

To compare rates of stillbirth among Haitians and non-Haitians in Canada.

Methods

A retrospective cohort study was performed using data on all stillborn and live-born singletons weighing at least 500 g in the province of Quebec, Canada, from 1981 to 2010. Stillbirth rates were computed, and hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for Haitians relative to non-Haitians. The main outcome measure was stillbirth by cause of death.

Results

Data for 9657 stillbirths (124 Haitian) and 2 414 751 live births (17 165 Haitian) were included. Stillbirth rates were higher for Haitians than non-Haitians (7.17 [95% CI 5.91–8.43] vs 3.96 [95% CI 3.88–4.04] per 1000 births), particularly for cord prolapse (adjusted HR 1.87, 95% CI 1.10–3.18) and placental abruption (adjusted HR 2.84, 95% CI 1.95–4.15). Haitians had higher risks of stillbirth due to cord prolapse and abruption at every week of pregnancy. Risks were not elevated for stillbirth due to congenital anomaly, a cause less responsive to urgent intervention.

Conclusion

Stillbirth rates among Haitians are disproportionately high in Canada, particularly fetal death due to cord prolapse and placental abruption. The potential to reduce stillbirth rates through optimal emergency care in vulnerable minorities requires further investigation.