Institut national d'études démographiques Institut national d'études démographiques(*) D.Sc. European Perinatal Transport Network, Maternité Port Royal, Paris.
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 case-control design with prospective identification of cases. It
includes all singleton non-malformed perinatal deaths wich occured between October 1, 1989
and September 30, 1992. Logistic regression is used to estimate odds ratios. Base
incidence rates are generated by incorporing 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 multivariates
models, however, only parity and country of origin are significants. Women born in the
french overseas departments and territories and Sub-Saharian 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 explainations such as standards of prenatal care, medical problems
during pregnancy and delivery, and cultural pratices should be explored.