SOCIODEMOGRAPHIC RISK-FACTORS FOR PERINATAL-MORTALITY - A STUDY OF PERINATAL-MORTALITY IN THE FRENCH DISTRICT OF SEINE-SAINT-DENIS

Objectives. To investigate the impact of a set of socio-demographic ri sk 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 in cludes all singleton non-malformed perinatal deaths which occurred bet ween October 1, 1989 and September 30, 1992, Logistic regression is us ed to estimate odds ratios. Base incidence rates are generated by inco rporating sampling information for the controls. Results. All socio-de mographic variables are significantly related to the risk of perinatal mortality in univariate analyses. Some of the increased risk due to s ocial factors is explained by differential age and parity distribution al In multivariate models, however, only parity and country of origin are significant. Women born in the French overseas departments and ter ritories and Sub-Saharan Africa have the highest odds ratios. Conclusi ons. 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 res idual variation in socioeconomic status, alternative explanations such as standards of prenatal care, medical problems during pregnancy and delivery, and cultural practices should be explored.