Ethnic disparities in stillbirth risk in Yunnan, China: a prospective cohort study, 2010-2018
Abstract Background Racial and ethnic disparities in stillbirth risk had been documented in most western countries, but it remains unknown in China. This study was to determine whether exist ethnic disparities in stillbirth risk in mainland China. Methods Pregnancy outcomes and ethnicity data were o...
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doaj-2802e01d003c42bfb8c7857a1bd206182021-01-17T12:04:10ZengBMCBMC Public Health1471-24582021-01-0121111010.1186/s12889-020-10102-yEthnic disparities in stillbirth risk in Yunnan, China: a prospective cohort study, 2010-2018Yanpeng Wu0Jianhong Pan1Dong Han2Lixin Li3Yanfei Wu4Rui Liao5Zijie Liu6Dingyun You7Pingyan Chen8Ying Wu9State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical UniversityState Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical UniversityThe Third Affiliated Hospital of Southern Medical UniversityState Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical UniversityThe First Affiliated Hospital of Zhengzhou UniversitySchool of Public Health, Kunming Medical University, NHC Key Laboratory of Periconception Health Birth in Western ChinaThe First Affiliated Hospital of Kunming Medical UniversitySchool of Public Health, Kunming Medical University, NHC Key Laboratory of Periconception Health Birth in Western ChinaState Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical UniversityState Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical UniversityAbstract Background Racial and ethnic disparities in stillbirth risk had been documented in most western countries, but it remains unknown in China. This study was to determine whether exist ethnic disparities in stillbirth risk in mainland China. Methods Pregnancy outcomes and ethnicity data were obtained from the National Free Preconception Health Examination Project (NEPHEP), a nationwide prospective population-based cohort study conducted in Yunnan China from 2010-2018. The Han majority and other four main minorities including Yi, Dai, Miao, Hani were investigated in the analysis. The stillbirth hazards were estimated by life-table analysis. The excess stillbirth risk (ESR) was computed for Chinese minorities using multivariable logistic regression. Results Compared with other four minorities, women in Han majority were more likely to more educated, less multiparous, and less occupied in agriculture. The pattern of stillbirth hazard of Dai women across different gestation intervals were found to be different from other ethnic groups, especially in 20-23 weeks with 3.2 times higher than Han women. The ESR of the Dai, Hani, Miao, and Yi were 45.05, 18.70, -4.17 and 12.28%, respectively. Adjusted for maternal age, education, birth order and other general risk factors, the ethnic disparity still persisted between Dai women and Han women. Adjusted for preterm birth further (gestation age <37 weeks) can reduce 16.91% ESR of Dai women and made the disparity insignificant. Maternal diseases and congenital anomalies explained little for ethnic disparities. Conclusions We identified the ethnic disparity in stillbirth risk between Dai women and Han women. General risk factors including sociodemographic factors and maternal diseases explained little. Considerable ethnic disparities can be attributed to preterm birth.https://doi.org/10.1186/s12889-020-10102-yStillbirthEthnic disparityChina |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yanpeng Wu Jianhong Pan Dong Han Lixin Li Yanfei Wu Rui Liao Zijie Liu Dingyun You Pingyan Chen Ying Wu |
spellingShingle |
Yanpeng Wu Jianhong Pan Dong Han Lixin Li Yanfei Wu Rui Liao Zijie Liu Dingyun You Pingyan Chen Ying Wu Ethnic disparities in stillbirth risk in Yunnan, China: a prospective cohort study, 2010-2018 BMC Public Health Stillbirth Ethnic disparity China |
author_facet |
Yanpeng Wu Jianhong Pan Dong Han Lixin Li Yanfei Wu Rui Liao Zijie Liu Dingyun You Pingyan Chen Ying Wu |
author_sort |
Yanpeng Wu |
title |
Ethnic disparities in stillbirth risk in Yunnan, China: a prospective cohort study, 2010-2018 |
title_short |
Ethnic disparities in stillbirth risk in Yunnan, China: a prospective cohort study, 2010-2018 |
title_full |
Ethnic disparities in stillbirth risk in Yunnan, China: a prospective cohort study, 2010-2018 |
title_fullStr |
Ethnic disparities in stillbirth risk in Yunnan, China: a prospective cohort study, 2010-2018 |
title_full_unstemmed |
Ethnic disparities in stillbirth risk in Yunnan, China: a prospective cohort study, 2010-2018 |
title_sort |
ethnic disparities in stillbirth risk in yunnan, china: a prospective cohort study, 2010-2018 |
publisher |
BMC |
series |
BMC Public Health |
issn |
1471-2458 |
publishDate |
2021-01-01 |
description |
Abstract Background Racial and ethnic disparities in stillbirth risk had been documented in most western countries, but it remains unknown in China. This study was to determine whether exist ethnic disparities in stillbirth risk in mainland China. Methods Pregnancy outcomes and ethnicity data were obtained from the National Free Preconception Health Examination Project (NEPHEP), a nationwide prospective population-based cohort study conducted in Yunnan China from 2010-2018. The Han majority and other four main minorities including Yi, Dai, Miao, Hani were investigated in the analysis. The stillbirth hazards were estimated by life-table analysis. The excess stillbirth risk (ESR) was computed for Chinese minorities using multivariable logistic regression. Results Compared with other four minorities, women in Han majority were more likely to more educated, less multiparous, and less occupied in agriculture. The pattern of stillbirth hazard of Dai women across different gestation intervals were found to be different from other ethnic groups, especially in 20-23 weeks with 3.2 times higher than Han women. The ESR of the Dai, Hani, Miao, and Yi were 45.05, 18.70, -4.17 and 12.28%, respectively. Adjusted for maternal age, education, birth order and other general risk factors, the ethnic disparity still persisted between Dai women and Han women. Adjusted for preterm birth further (gestation age <37 weeks) can reduce 16.91% ESR of Dai women and made the disparity insignificant. Maternal diseases and congenital anomalies explained little for ethnic disparities. Conclusions We identified the ethnic disparity in stillbirth risk between Dai women and Han women. General risk factors including sociodemographic factors and maternal diseases explained little. Considerable ethnic disparities can be attributed to preterm birth. |
topic |
Stillbirth Ethnic disparity China |
url |
https://doi.org/10.1186/s12889-020-10102-y |
work_keys_str_mv |
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