Cross-country variation in stillbirth and neonatal mortality in offspring of Turkish migrants in northern Europe.
BACKGROUND
Diverse early-life mortality outcomes have been documented in immigrant populations in northern Europe. A recent meta-analysis has suggested that national integration policy is a key factor in understanding this heterogeneous pattern. In this study, we investigated the variation of stillbirth and neonatal mortality between societies in northern Europe in one minority population, the Turkish.


METHODS
Data on stillbirth and neonatal deaths in 239 387 births during 1990-2005, where the mother was of Turkish origin, was drawn from birth registries or surveys in nine northern European countries. Rates were compared with births from mothers who were born in the society of residence. Logistic regression was used to calculate odds ratios adjusted for year of birth of the offspring.


RESULTS
The risks for stillbirth were, or tended to be, elevated for Turkish mothers in all countries compared with the native population, with the highest risk in Austria (odds ratio (OR) 1.7; 95% confidence interval (CI) 1.4-2.1) and Switzerland (OR 1.6; 1.4-1.9). For neonatal mortality the results were heterogeneous, indicating no excess risk for Turkish-born children in the Netherlands, the UK and Norway, and elevated risks in Denmark (OR 1.3; 1.0-1.6), Switzerland (OR 1.3; 1.1-1.5), Austria (OR 1.4; 1.0-1.8) and Germany (OR 1.3; CI 1.2-1.5).


CONCLUSIONS
This study suggests that preventable society-specific determinants are important for early-life mortality in Turkish migrants in Europe. An active integration policy is consistent with a favourable neonatal mortality outcome in continental Europe, but not with patterns in Scandinavia and the UK.
Villadsen
Sarah Fredsted
SF
Institute of Human Nutrition, University of Copenhagen, Rolighedsvej 30, Frederiksberg C, Denmark.
Sievers
Erika
E
Andersen
Anne-Marie Nybo
AM
Arntzen
Annett
A
Audard-Mariller
Marjorie
M
Martens
Guy
G
Ascher
Henry
H
Hjern
Anders
A
D000293:Adolescent; D000328:Adult; D002648:Child; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007226:Infant Mortality / Q000208:ethnology*; D007231:Infant, Newborn; D008913:Minority Groups / Q000706:statistics & numerical data; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D012044:Regression Analysis; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology / Q000208:ethnology*; D014421:Turkey / Q000208:ethnology; D055815:Young Adult