Socio-demographic risk factors for perinatal mortality. A study of perinatal mortality in the French district of Seine-Saint-Denis

Abstract

Objectives: To investigate the impact of a set of socio-demographic risk factors commonly associated with perinatal mortality -- age, parity, marital status, educational attainment, occupation, and ethnic origin in the French district of Seine-Saint-Denis.

Methods: The study has a case-control design with prospective identification of cases. It includes all singleton non-malformed perinatal deaths which occurred between October 1, 1989 and September 30, 1992. Logistic regression is used to estimate odds ratios. Base incidence rates are generated by incorporating sampling information for the controls.

Results: All socio-demographic variables are significantly related to the risk of perinatal mortality in univariate analyses. Some of the increased risk due to social factors is explained by differential age and parity distributions. In multivariate models, however, only parity and country of origin are significant. Women born in the French overseas departments and territories and Sub-Saharan Africa have the highest odds ratios.

Conclusions: Women born outside of continental France face an elevated risk of experiencing a perinatal death even after controlling for age, parity and socioeconomic factors. Although, this excess risk may reflect residual variation in socioeconomic status, alternative explanations such as standards of prenatal care, medical problems during pregnancy and delivery, and cultural practices should be explored.