title: [Differences in perinatal mortality between districts of Amsterdam].
abstract: OBJECTIVE
  To study the effect of district on perinatal mortality in Amsterdam, the Netherlands, taking into account various risk factors including ethnicity and social economic status (SES).
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  The investigation related to 73,661 singleton births in Amsterdam, Diemen and Ouder-Amstel recorded in the Netherlands Perinatal Registry over the years 2000-2006. Logistic regression analysis was used to determine if perinatal mortality differed by district, taking into account various risk factors.
  
  
  RESULTS
  Each year in Amsterdam an average of 10,525 singleton children were born of whom 114 infants died (10.8 per 1,000 births (‰)). National perinatal mortality was 9.9 ‰. In three districts, perinatal mortality was 1.5-2 times higher than the national average: Zuidoost (21‰), Slotervaart (14‰) and Zeeburg (14‰). However, mortality in the districts of ZuiderAmstel (5‰), Oud-Zuid (7‰), Centrum and Osdorp (8‰) was 20-50% lower. The high risk of perinatal mortality in the Zuidoost district (odds ratio: 2.1; 95% CI: 1.9-2.6) was explained by the high prevalence of women with higher risk factors; African or South Asian Surinamese ethnicity, low SES and preterm birth. The effects of parity and ethnicity on perinatal mortality differed by district. In Zeeburg increased effect for higher parity and for Turkish/Moroccan ethnicity was seen. In Slotervaart the perinatal mortality risk was increased (odds ratio: 1.8; 95% CI: 1.3-2.5), but this was not explained by the risk factors studied.
  
  
  CONCLUSIONS
  Amsterdam had districts with both highly elevated and reduced perinatal mortality rates. The prevalence of risk factors differed by district and the effects of ethnicity and parity were not homogenous. Therefore, tailored policy and research by district is necessary.
authors.affiliation: Academisch Medisch Centrum, Afd. Klinische Informatiekunde, Amsterdam, the Netherlands. a.c.ravelli@amc.uva.nl
authors.forename: Anita C J
authors.initials: AC
authors.lastname: Ravelli
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
authors.forename: Greta C
authors.initials: GC
authors.lastname: Rijninks-van Driel
authors.forename: Ameen
authors.initials: A
authors.lastname: Abu-Hanna
authors.forename: Martine
authors.initials: M
authors.lastname: Eskes
authors.forename: Arnoud P
authors.initials: AP
authors.lastname: Verhoeff
authors.forename: Simone E
authors.initials: SE
authors.lastname: Buitendijk
authors.forename: Karien
authors.initials: K
authors.lastname: Stronks
authors.forename: Joris A M
authors.initials: JA
authors.lastname: van der Post
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007226:Infant Mortality / Q000208:ethnology; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands; D010298:Parity; D018743:Perinatal Care / Q000706:statistics & numerical data*; D054238:Perinatal Mortality / Q000208:ethnology; D011247:Pregnancy; D047928:Premature Birth / Q000401:mortality; D012042:Registries; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult