Differences in preterm delivery rates and outcomes in Jews and Bedouins insouthern Israel

Objective: (1) To compare the preterm delivery rates in the Bedouin versus the Jewish population. (2) To compare risk factors for preterm delivery in the two populations. (3) To compare outcomes of preterm delivery between th e two groups. Study design: 41 669 Jewish singletons births of whom 2816 de livered preterm (23-36 weeks) and 26 495 Bedouin singletons in whom 2064 pr eterm deliveries occurred, were compared. All births Look place in Soroka U niversity Medical Center. Data were obtained from the computerized database of birth discharge records. Results: The incidence of preterm delivery in Bedouin women was significantly higher than the rate in Jewish women (7.8 v s. 6.8%, P<0.01). The grand multiparity rate was higher among Bedouin women (P<0.001), as was the rate of teenage (<19 years) mothers (P<0.001). Gesta tional diabetes, PIH, and FROM rates were higher in the Jewish population ( P<0.001, P=0.017, P<0.001, respectively). A bad obstetric history and previ ous perinatal mortality is more common in the Bedouin population (P<0.001 f or both). In a logistic regression model including all these factors, the e thnic difference in the incidence of preterm delivery remained significant. The neonatal mortality rate was higher in the Bedouin population (P<0.001) , as was the rate of congenital malformations (P<0.001). The perinatal mort ality of Bedouins was neatly twice that of Jewish neonates with congenital malformations. However, no difference was found when neonates without conge nital malformations were compared. Congenital malformations were found to b e the strongest predictor of mortality. Ethnicity per se was no longer a pr edictor of mortality once congenital malformations were included in a logis tic regression model, but the interaction of Bedouin ethnicity and congenit al malformation was a significant predictor of mortality. Conclusion: The i ncidence of preterm delivery was significantly higher in Bedouin women than in Jewish women. A full explanation for this difference was not found. How ever, there were significantly higher rates of congenital malformations in the Bedouin preterm delivered infants. There was a much higher rate of neon atal mortality in the Bedouin population and this ethnic difference was ful ly explained by the presence of congenital anomalies. (C) 2000 Elsevier Sci ence Ireland Ltd. All rights reserved.