| Titre : | Trends in maternal mortality ratio among women of German and non-German nationality in West germany, 1980-1996. (1999) |
| Auteurs : | O. RAZUM ; M. BLETTNER ; A. JAHN ; P. REITMAIER ; Department of Tropical Hygiene and Public Health. Heidelberg. DEU |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 28, n° 5, 1999) |
| Pagination : | 919-924 |
| Langues: | Anglais |
| Mots-clés : | Mortalité maternelle ; Mortalité ; Mère ; Taux ; Ratio ; Ethnie ; Immigration ; Epidémiologie ; Evolution ; Facteur risque ; Homme ; Femme ; Allemagne ; Europe |
| Résumé : | [BDSP. Notice produite par INIST f38R0xU1. Diffusion soumise à autorisation]. Background Maternal mortality is a sensitive indicator for inequity in health. We describe recent trends in overall and cause-specific maternal mortality ratio among women of German and non-German nationality residing in West Germany. Methods Using birth and death register data for 1980-1996 we related 1067 cases of maternal death (ICD 9 : 630-676) to 11.2 million live births. We assessed the effects of nationality and of marital status, a proxy for socioeconomic status, controlling for year of death and age of the mother in a Poisson regression model. Results Maternal mortality ratio in West Germany decreased from 13 per 100 000 live births in 1980-1988 to 6.1 in 1989-1996. The crude relative risk for non-German nationality decreased from 1.9 (95% CI : 1.6-2.3) to 1.3 (1.0-1.7) ; after adjusting for age, year of death and marital status it was 1.7 (95% CI : 1.4-2.1) and 1.6 (95% CI : 1.2-2.1). Unmarried women incurred an adjusted relative risk of 1.8 (95% CI : 1.5-2.3). Non-German women experienced an excess mortality from abortions which largely disappeared in 1989-1996 ; concurrently, being unmarried no longer conveyed an additional risk to them. The risk status of German mothers developed unfavourably : increasing proportions are unmarried, which continues to be a marker of elevated relative risk in this group. Conclusions Our findings suggest continuously improving accessibility and quality of obstetric services, in particular for women of non-German nationality. (...) |
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