Department of Obstetrics, Gynecology and Women's Health, University of Minnesota School of Medicine, Medical School MMC 395, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota School of Medicine, Global Women's Health, Center for Global Health and Social Responsibility, Medical School MMC 395, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
BMC Pregnancy Childbirth. 2021 Nov 1;21(1):740. doi: 10.1186/s12884-021-04163-z.
Somali women deliver at greater gestational age with limited information on the associated perinatal mortality. Our objective is to compare perinatal mortality among Somali women with the population rates.
This is a retrospective cohort study from all births that occurred in Minnesota between 2011 and 2017. Information was obtained from certificates of birth, and neonatal and fetal death. Data was abstracted from 470,550 non-anomalous births ≥37 and ≤ 42 weeks of gestation. The study population included U.S. born White, U.S. born Black, women born in Somalia or self-identified as Somali, and women who identified as Hispanic regardless of place of birth (377,426). We excluded births < 37 weeks and > 42 weeks, > 1 fetus, age < 18 or > 45 years, or women of other ethnicities. The exposure was documented ethnicity or place of birth, and the outcomes were live birth, fetal death, neonatal death prior to 28 days, and perinatal mortality rates. These were calculated using binomial proportions with 95% confidence intervals and compared using odds ratios adjusted (aOR) for diabetes, hypertension and maternal body mass index.
The aOR [95%CI] for stillbirth rate in the Somali cohort was greater than for U.S. born White (2.05 [1.49-2.83]) and Hispanic women (1.90 [1.30-2.79]), but similar to U.S. born Black women (0.88 [0.57-1.34]). Neonatal death rates were greater than for U.S. born White (1.84 [1.36-2.48], U.S. born Black women (1.47 [1.04-2.06]) and Hispanic women (1.47 [1.05-2.06]). This did not change after analysis was restricted to those with spontaneous onset of labor. When analyzed by week, at 42 weeks Somali aOR for neonatal death was the same as for U.S. born White women, but compared against U.S. born Black and Hispanic women, was significantly lower.
The later mean gestational age at delivery among women of Somali ethnicity is associated with greater overall risk for stillbirth and neonatal death rates at term, except compared against U.S. born Black women with whom stillbirth rates were not different. At 42 weeks, Somali neonatal mortality decreased and was comparable to that of the U.S. born White population and was lower than that of the other minorities.
索马里妇女在妊娠晚期分娩的比例较高，但有关围产期死亡率的信息有限。我们的目的是比较索马里妇女的围产期死亡率与人群比率。
这是一项回顾性队列研究，对象为 2011 年至 2017 年期间在明尼苏达州出生的所有婴儿。信息来自出生证明、新生儿和胎儿死亡证明。数据来自 470550 名≥37 周且≤42 周足月出生的非畸形婴儿。研究人群包括美国出生的白人、美国出生的黑人、出生于索马里或自认为是索马里人的妇女，以及无论出生地如何都自认为是西班牙裔的妇女（377426 人）。我们排除了<37 周和>42 周、>1 个胎儿、年龄<18 岁或>45 岁或其他族裔的分娩。暴露是记录种族或出生地，结局是活产、胎儿死亡、28 天前新生儿死亡和围产期死亡率。这些结局使用二项式比例计算，置信区间为 95%，并使用调整糖尿病、高血压和产妇体重指数的比值比（aOR）进行比较。
索马里队列的死胎率的 aOR [95%CI] 高于美国出生的白人（2.05 [1.49-2.83]）和西班牙裔妇女（1.90 [1.30-2.79]），但与美国出生的黑人妇女（0.88 [0.57-1.34]）相似。新生儿死亡率高于美国出生的白人（1.84 [1.36-2.48]）、美国出生的黑人妇女（1.47 [1.04-2.06]）和西班牙裔妇女（1.47 [1.05-2.06]）。这一结果在对自发性临产的患者进行分析后并未改变。按周分析时，42 周时索马里的新生儿死亡 aOR 与美国出生的白人妇女相同，但与美国出生的黑人妇女和西班牙裔妇女相比，明显较低。
索马里族裔妇女的平均分娩孕周较晚，与足月时死产和新生儿死亡率的整体风险增加相关，但与美国出生的黑人妇女相比，死产率没有差异。在 42 周时，索马里新生儿死亡率下降，与美国出生的白人人口相当，且低于其他少数族裔。
