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

被引:26
作者
Melamed, Y
Bashiri, A
Shoham-Vardi, I
Furman, B
Hackmon-Ram, R
Mazor, M
机构
[1] Ben Gurion Univ Negev, Fac Hlth Sci, Soroka Univ Med Ctr, Dept Obstet & Gynecol, IL-84101 Beer Sheva, Israel
[2] Ben Gurion Univ Negev, Fac Hlth Sci, Soroka Univ Med Ctr, Epidemiol Unit, IL-84101 Beer Sheva, Israel
来源
EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY | 2000年 / 93卷 / 01期
关键词
preterm delivery; perinatal mortality; congenital malformations; ethnicity;
D O I
10.1016/S0301-2115(00)00240-2
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
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 the two groups. Study design: 41 669 Jewish singletons births of whom 2816 delivered preterm (23-36 weeks) and 26 495 Bedouin singletons in whom 2064 preterm deliveries occurred, were compared. All births Look place in Soroka University 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 vs. 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). Gestational 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 previous perinatal mortality is more common in the Bedouin population (P<0.001 for both). In a logistic regression model including all these factors, the ethnic 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 mortality of Bedouins was neatly twice that of Jewish neonates with congenital malformations. However, no difference was found when neonates without congenital malformations were compared. Congenital malformations were found to be the strongest predictor of mortality. Ethnicity per se was no longer a predictor of mortality once congenital malformations were included in a logistic regression model, but the interaction of Bedouin ethnicity and congenital malformation was a significant predictor of mortality. Conclusion: The incidence of preterm delivery was significantly higher in Bedouin women than in Jewish women. A full explanation for this difference was not found. However, there were significantly higher rates of congenital malformations in the Bedouin preterm delivered infants. There was a much higher rate of neonatal mortality in the Bedouin population and this ethnic difference was fully explained by the presence of congenital anomalies. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.
引用
收藏
页码:41 / 46
页数:6
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