Ethnic differences in perinatal mortality--a challenge.

Abstract

The perinatal mortality rates of mothers who delivered at St. Thomas''s Hospital [London, England, UK] from 1969-1976 were examined. The rate in the West Indian population was significantly higher than in the UK white population. The increased West Indian mortality was confined to infants with a birth weight of more than 2.0 kg and a gestational age of more than 37 wk. The relative risk of perinatal death for West Indian mothers compared with UK white mothers was 1.4 at birth weights of 2.5-2.9 kg, rising to 4.3 at 4.0+ kg. West Indian perinatal mortality in term babies of normal birth weight was higher in all maternal age and parity groups except parity 3, but the difference was greatest in women aged 30 yr or over. The African perinatal mortality rate was not significantly greater than the UK white rate although it followed the West Indian trends. Preeclampsia and forceps delivery were associated with a greatly increased perinatal mortality in West Indian babies. The excess West Indian mortality could not be explained completely by differences in the proportions of stillbirths and early neonatal deaths nor by the distribution of births by parity, maternal age or social class. Possible explanations for the differences in mortality are discussed.