BACKGROUND: Inuit and First Nations populations have higher rates of stillbirth than non-Aboriginal populations in Canada do, but little is known about the timing and cause of stillbirth in Aboriginal populations. We compared gestational age- and cause-specific stillbirth rates in Inuit and First Nations populations with the rates in the non-Aboriginal population in Quebec. METHODS: Data included singleton stillbirths and live births at 24 or more gestational weeks among Quebec residents from 1981 to 2009. We calculated odds ratios (ORs), rate differences and 95% confidence intervals (CIs) for the retrospective cohort of Inuit and First Nations births relative to non-Aboriginal births using fetuses at risk (i.e., ongoing pregnancies) as denominators and adjusting for maternal characteristics. The main outcomes were stillbirth by gestational age (24-27, 28-36, ≥ 37 wk) and cause of death. RESULTS: Rates of stillbirth per 1000 births were greater among Inuit (6.8) and First Nations (5.7) than among non-Aboriginal (3.6) residents. Relative to the non-Aboriginal population, the risk of stillbirth was greater at term (≥ 37 wk) than before term for both Inuit (OR 3.1, 95% CI 1.9 to 4.8) and First Nations (OR 2.6, 95% CI 2.1 to 3.3) populations. Causes most strongly associated with stillbirth were poor fetal growth, placental disorders and congenital anomalies among the Inuit, and hypertension and diabetes among the First Nations residents. INTERPRETATION: Stillbirth rates in Aboriginal populations were particularly high at term gestation. Poor fetal growth, placental disorders and congenital anomalies were important causes of stillbirth among the Inuit, and diabetic and hypertensive complications were important causes in the First Nations population. Prevention may require improvements in pregnancy and obstetric care.
BACKGROUND: Inuit and First Nations populations have higher rates of stillbirth than non-Aboriginal populations in Canada do, but little is known about the timing and cause of stillbirth in Aboriginal populations. We compared gestational age- and cause-specific stillbirth rates in Inuit and First Nations populations with the rates in the non-Aboriginal population in Quebec. METHODS: Data included singleton stillbirths and live births at 24 or more gestational weeks among Quebec residents from 1981 to 2009. We calculated odds ratios (ORs), rate differences and 95% confidence intervals (CIs) for the retrospective cohort of Inuit and First Nations births relative to non-Aboriginal births using fetuses at risk (i.e., ongoing pregnancies) as denominators and adjusting for maternal characteristics. The main outcomes were stillbirth by gestational age (24-27, 28-36, ≥ 37 wk) and cause of death. RESULTS: Rates of stillbirth per 1000 births were greater among Inuit (6.8) and First Nations (5.7) than among non-Aboriginal (3.6) residents. Relative to the non-Aboriginal population, the risk of stillbirth was greater at term (≥ 37 wk) than before term for both Inuit (OR 3.1, 95% CI 1.9 to 4.8) and First Nations (OR 2.6, 95% CI 2.1 to 3.3) populations. Causes most strongly associated with stillbirth were poor fetal growth, placental disorders and congenital anomalies among the Inuit, and hypertension and diabetes among the First Nations residents. INTERPRETATION: Stillbirth rates in Aboriginal populations were particularly high at term gestation. Poor fetal growth, placental disorders and congenital anomalies were important causes of stillbirth among the Inuit, and diabetic and hypertensive complications were important causes in the First Nations population. Prevention may require improvements in pregnancy and obstetric care.
Authors: Philippe De Wals; Fassiatou Tairou; Margot I Van Allen; Soo-Hong Uh; R Brian Lowry; Barbara Sibbald; Jane A Evans; Michiel C Van den Hof; Pamela Zimmer; Marian Crowley; Bridget Fernandez; Nora S Lee; Theophile Niyonsenga Journal: N Engl J Med Date: 2007-07-12 Impact factor: 91.245
Authors: David Reich; Nick Patterson; Desmond Campbell; Arti Tandon; Stéphane Mazieres; Nicolas Ray; Maria V Parra; Winston Rojas; Constanza Duque; Natalia Mesa; Luis F García; Omar Triana; Silvia Blair; Amanda Maestre; Juan C Dib; Claudio M Bravi; Graciela Bailliet; Daniel Corach; Tábita Hünemeier; Maria Cátira Bortolini; Francisco M Salzano; María Luiza Petzl-Erler; Victor Acuña-Alonzo; Carlos Aguilar-Salinas; Samuel Canizales-Quinteros; Teresa Tusié-Luna; Laura Riba; Maricela Rodríguez-Cruz; Mardia Lopez-Alarcón; Ramón Coral-Vazquez; Thelma Canto-Cetina; Irma Silva-Zolezzi; Juan Carlos Fernandez-Lopez; Alejandra V Contreras; Gerardo Jimenez-Sanchez; Maria José Gómez-Vázquez; Julio Molina; Angel Carracedo; Antonio Salas; Carla Gallo; Giovanni Poletti; David B Witonsky; Gorka Alkorta-Aranburu; Rem I Sukernik; Ludmila Osipova; Sardana A Fedorova; René Vasquez; Mercedes Villena; Claudia Moreau; Ramiro Barrantes; David Pauls; Laurent Excoffier; Gabriel Bedoya; Francisco Rothhammer; Jean-Michel Dugoujon; Georges Larrouy; William Klitz; Damian Labuda; Judith Kidd; Kenneth Kidd; Anna Di Rienzo; Nelson B Freimer; Alkes L Price; Andrés Ruiz-Linares Journal: Nature Date: 2012-08-16 Impact factor: 49.962
Authors: Maria P Vélez; Morgan Slater; Rebecca Griffiths; Baiju R Shah; Roseanne Sutherland; Carmen Jones; Kristen Jacklin; Jennifer D Walker; Michael E Green Journal: CMAJ Open Date: 2020-03-19