Increased perinatal mortality among sub-Saharan immigrants in a city-population in Sweden

Background The aim of the study was to investigate whether the maternal cou ntry of origin affected the risk for perinatal mortality and to determine i ts relationship to risk factors. Methods. A study of 15,639 deliveries in Malmo, Sweden. Data regarding demo graphic factors, life-style and perinatal risk factors, together with data pertaining to outcome was obtained from the Malmo database and the Swedish Medical Birth Register. Results. Perinatal mortality was increased among infants to women of Foreig n origin as compared to those delivered by women of Swedish origin (OR 1.5, CI 1.0-2.2). Even after adjustments for maternal background and risk facto rs (diabetes, anemia, pre-eclampsia, placental abruption and small-for-gest ational age), the increased risk of perinatal mortality among women of Fore ign origin remained statistically significant. Women from sub-Saharan Afric a, comprising 7.3% of all immigrants, differed from all other subgroups of women of foreign origin by having a higher risk of adverse outcome (small-f or-gestational age OR 1.9, CI 1.0-3.6, neonatal distress OR 2.7, CI 5.1-4.8 and perinatal mortality OR 4.3, CI 2.1-8.6). Conclusions. Women of foreign origin, especially from sub-Saharan Africa, h ave a higher risk of perinatal mortality than native Swedish women. The dif ferences in mortality could not be explained by risk factors. The results s uggest that women and newborns from sub-Saharan Africa should be given more intense surveillance on all levels of perinatal care in order to reduce pe rinatal mortality.