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Are some perinatal deaths in immigrant groups linked to sub-optimal perinatal care services? Perinatal audit of infants to women from Africa’s Horn delivered in Sweden 1990-96

Essén, Birgitta LU ; Bödker, Birgit; Sjöberg, Nils-Otto LU ; Langhoff-Roos, Jens; Greisen, Gorm; Gudmundsson, Saemundur LU and Östergren, Per-Olof LU (2002) In BJOG: An International Journal of Obstetrics & Gynaecology2000-01-01+01:00 109(6). p.677-682
Abstract
Objective: To test the hypothesis that sub-optimal factors in perinatal care services resulting in perinatal deaths were more common among immigrant mothers from the Horn of Africa, as compared to Swedish mothers.



Design: A perinatal audit, comparing cases of perinatal deaths among children of African immigrants residing in Sweden, with a stratified sample of cases among native Swedish women.



Setting: Sixty-three cases of perinatal deaths among immigrant east African women delivered in Swedish hospitals in 1990–1996, and 126 cases of perinatal deaths among native Swedish women. Time of death and type of hospital were stratified.



Main outcome measures: Sub-optimal factors in perinatal... (More)
Objective: To test the hypothesis that sub-optimal factors in perinatal care services resulting in perinatal deaths were more common among immigrant mothers from the Horn of Africa, as compared to Swedish mothers.



Design: A perinatal audit, comparing cases of perinatal deaths among children of African immigrants residing in Sweden, with a stratified sample of cases among native Swedish women.



Setting: Sixty-three cases of perinatal deaths among immigrant east African women delivered in Swedish hospitals in 1990–1996, and 126 cases of perinatal deaths among native Swedish women. Time of death and type of hospital were stratified.



Main outcome measures: Sub-optimal factors in perinatal care services, categorised as maternal, medical care, and communication.



Results: The rate of sub-optimal factors likely to result in potentially avoidable perinatal death was significantly higher among African immigrants. In the group of antenatal deaths, the OR was 6.2 (CI 1.9-20); the OR for intrapartal deaths was 13 (CI 1.1-166); and the OR for neonatal deaths was 18 (CI 3.3-100), when compared with Swedish mothers. The most common factors were delay in seeking health care, mothers refusing caesarean sections, insufficient surveillance of IUGR (intrauterine growth restriction), inadequate medication, misinterpretation of CTG (cardiotocography), and interpersonal miscommunication.



Conclusions: Sub-optimal factors in perinatal care likely to result in perinatal death were significantly more common among east African than native Swedish mothers, affording insight into socio-cultural differences in pregnancy strategies, but also the sub-optimal performance of certain health-care routines in the Swedish perinatal care system. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Quality of Health Care, Risk Factors, Emigration and Immigration, Cohort Studies, Adult, Africa : ethnology, Sweden : epidemiology, Non-U.S. Gov't, Support, Perinatal Care : standards, Medical Audit, Newborn, Infant, Infant Mortality, Female, Human
in
BJOG: An International Journal of Obstetrics & Gynaecology2000-01-01+01:00
volume
109
issue
6
pages
677 - 682
publisher
Wiley-Blackwell
external identifiers
  • wos:000177328700015
ISSN
1471-0528
DOI
10.1111/j.1471-0528.2002.01077.x
language
English
LU publication?
yes
id
5d88440d-d98c-4643-b63d-92d62048c6c5 (old id 914723)
date added to LUP
2008-01-09 12:44:07
date last changed
2016-04-16 03:33:17
@article{5d88440d-d98c-4643-b63d-92d62048c6c5,
  abstract     = {Objective: To test the hypothesis that sub-optimal factors in perinatal care services resulting in perinatal deaths were more common among immigrant mothers from the Horn of Africa, as compared to Swedish mothers.<br/><br>
<br/><br>
Design: A perinatal audit, comparing cases of perinatal deaths among children of African immigrants residing in Sweden, with a stratified sample of cases among native Swedish women.<br/><br>
<br/><br>
Setting: Sixty-three cases of perinatal deaths among immigrant east African women delivered in Swedish hospitals in 1990–1996, and 126 cases of perinatal deaths among native Swedish women. Time of death and type of hospital were stratified.<br/><br>
<br/><br>
Main outcome measures: Sub-optimal factors in perinatal care services, categorised as maternal, medical care, and communication.<br/><br>
<br/><br>
Results: The rate of sub-optimal factors likely to result in potentially avoidable perinatal death was significantly higher among African immigrants. In the group of antenatal deaths, the OR was 6.2 (CI 1.9-20); the OR for intrapartal deaths was 13 (CI 1.1-166); and the OR for neonatal deaths was 18 (CI 3.3-100), when compared with Swedish mothers. The most common factors were delay in seeking health care, mothers refusing caesarean sections, insufficient surveillance of IUGR (intrauterine growth restriction), inadequate medication, misinterpretation of CTG (cardiotocography), and interpersonal miscommunication.<br/><br>
<br/><br>
Conclusions: Sub-optimal factors in perinatal care likely to result in perinatal death were significantly more common among east African than native Swedish mothers, affording insight into socio-cultural differences in pregnancy strategies, but also the sub-optimal performance of certain health-care routines in the Swedish perinatal care system.},
  author       = {Essén, Birgitta and Bödker, Birgit and Sjöberg, Nils-Otto and Langhoff-Roos, Jens and Greisen, Gorm and Gudmundsson, Saemundur and Östergren, Per-Olof},
  issn         = {1471-0528},
  keyword      = {Quality of Health Care,Risk Factors,Emigration and Immigration,Cohort Studies,Adult,Africa : ethnology,Sweden : epidemiology,Non-U.S. Gov't,Support,Perinatal Care : standards,Medical Audit,Newborn,Infant,Infant Mortality,Female,Human},
  language     = {eng},
  number       = {6},
  pages        = {677--682},
  publisher    = {Wiley-Blackwell},
  series       = {BJOG: An International Journal of Obstetrics & Gynaecology2000-01-01+01:00},
  title        = {Are some perinatal deaths in immigrant groups linked to sub-optimal perinatal care services? Perinatal audit of infants to women from Africa’s Horn delivered in Sweden 1990-96},
  url          = {http://dx.doi.org/10.1111/j.1471-0528.2002.01077.x},
  volume       = {109},
  year         = {2002},
}