Trends in maternal mortality in Switzerland among Swiss and foreign nationals, 1969-2006.
OBJECTIVE
To test whether maternal mortality was higher among immigrant women than Swiss women.


METHODS
All maternal deaths and live births in Switzerland from 1969 to 2006 from official vital statistics were considered. We calculated maternal mortality ratios (MMRs) in four time intervals (1969-1979, 1980-1989, 1990-1999, 2000-2006) for both Swiss and immigrant women overall, and for Italian, Spanish and Turkish women. We also computed the odds ratios and 95% confidence intervals of maternal mortality over the four time periods, considering maternal deaths as cases, and live births as controls.


RESULTS
From 1969 to 2006 there were 279 maternal deaths, 204 of Swiss women and 75 of immigrant women. Women's age, marital status and cause of death were similar in the two groups. For immigrant women, the crude odds ratio of a pregnancy ending with maternal death, not homogeneous across the four periods, was 4.38 (95% CI 1.88-10.55) in 2000-2006.


CONCLUSIONS
Immigrant women have a higher risk of maternal mortality than Swiss women. A closer scrutiny of risk factors and quality of care is necessary to identify opportunities for prevention.
Services for Medical Research forMed, Evolène, Switzerland. formed.mail@gmail.com
Paola
P
Bollini
Philippe
P
Wanner
Sandro
S
Pampallona
D000328:Adult; D002423:Cause of Death; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D050498:Live Birth / Q000208:ethnology*; D008428:Maternal Mortality / Q000208:ethnology / Q000639:trends*; D011247:Pregnancy; D012042:Registries; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult