Danke K, Blecher C, Bardehle D, Cremer D, Razum O
Universität Bielefeld, Fakultät Gesundheitswissenschaften.
Gesundheitswesen. 2008 Nov;70(11):624-30. doi: 10.1055/s-0028-1100391. Epub 2008 Nov 27.
From 2002 to 2005 the infant mortality rate in the city of Bielefeld has been higher than that of the state of North Rhine Westphalia, in which Bielefeld is located. The 3-year average in Bielefeld was 7.3 vs. 4.7 per 1 000 live births in the period 2002-2004. The aim of our study was to examine the causes of the elevated infant mortality in Bielefeld.
We conducted a small area analysis and an analysis of the migration status of parents and children in the context of infant mortality. We collected data from death certificates stored at the health office of Bielefeld and coded the cause of death according to ICD-10. We extracted nationality and country of birth from the local population registry.
The most frequent causes of death were perinatal factors, malformations and sudden infant death syndrome. Three city districts with a high proportion of population groups with specific sociological risks had an elevated infant mortality. Among infants of migrants, malformations were a more common cause of death (40% of all deaths) than among those without migration background. Perinatal causes were less common among infants with a migration background than without one (42% vs. 54%. of deaths). The authors question whether or not a cause-effect relationship exists here.
The infant mortality rate and the proportion of low birth-weight infants are associated with the social status. Thus, infant mortality is not distributed evenly within a city, either in geographic or in sociological terms. Conversely, statistics about infant mortality define focal points which can be identified and improved. Analysis according to migration background and socio-spatial structures can help to assess health care provided and to initiate targeted interventions, e.g., via local health conferences.
2002年至2005年期间，比勒费尔德市的婴儿死亡率高于其所在的北莱茵-威斯特法伦州。2002 - 2004年期间，比勒费尔德市的三年平均婴儿死亡率为每1000例活产7.3例，而该州为4.7例。我们研究的目的是调查比勒费尔德市婴儿死亡率升高的原因。
我们进行了小区域分析，并在婴儿死亡率的背景下分析了父母和儿童的移民状况。我们从比勒费尔德市卫生局存储的死亡证明中收集数据，并根据国际疾病分类第10版（ICD - 10）对死因进行编码。我们从当地人口登记处提取了国籍和出生国家。
最常见的死因是围产期因素、畸形和婴儿猝死综合征。三个具有特定社会学风险人群比例较高的城市区婴儿死亡率升高。在移民婴儿中，畸形是比无移民背景婴儿更常见的死因（占所有死亡的40%）。围产期原因在有移民背景的婴儿中比无移民背景的婴儿中更不常见（分别为42%和54%的死亡）。作者质疑这里是否存在因果关系。
婴儿死亡率和低体重婴儿比例与社会地位相关。因此，无论是在地理上还是社会学上，婴儿死亡率在城市内的分布都不均衡。相反，婴儿死亡率统计数据确定了可以识别和改善的重点区域。根据移民背景和社会空间结构进行分析有助于评估所提供的医疗保健，并启动有针对性的干预措施，例如通过当地的健康会议。
