Francophone and Anglophone perinatal health: temporal and regional inequalities in a Canadian setting, 1981-2008.
OBJECTIVE
We evaluated temporal and regional inequalities in adverse birth outcomes between Anglophones and Francophones of a Canadian province.


METHODS
Odds ratios and rate differences in preterm birth (PTB, <37 gestational weeks) and small-for-gestational-age (SGA) birth were computed for Anglophones relative to Francophones for singleton live births in Québec from 1981 to 2008 (N = 2,292,237), adjusting for maternal characteristics. Trends over time and residential region were evaluated.


RESULTS
Rates of PTB and SGA birth overall were lower for Anglophones relative to Francophones, but temporal and regional trends varied by outcome. Although PTB rates increased over time, inequalities between Francophones and Anglophones were relatively stable. In contrast, inequalities in SGA birth narrowed over time as Francophone rates declined more than Anglophones. Inequalities in SGA birth favored Anglophones overall, but the gap gradually reversed in Montréal (the largest metropolitan center) to currently favor Francophones.


CONCLUSIONS
PTB and SGA birth rates favored Anglophones over Francophones. The linguistic gap was generally stable over time for PTB, but narrowed or reversed for SGA birth. Language may be used to capture inequalities in perinatal health in countries where different linguistic groups predominate.
Institut national de santé publique du Québec, 190, boulevard Crémazie Est, Montréal, QC H2P 1E2, Canada. nathalie.auger@inspq.qc.ca
Nathalie
N
Auger
Alison L
AL
Park
Sam
S
Harper
D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007802:Language; D016017:Odds Ratio; D058725:Peripartum Period; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology / Q000208:ethnology*; D047928:Premature Birth / Q000453:epidemiology / Q000208:ethnology*; D015995:Prevalence; D011792:Quebec / Q000453:epidemiology; D012042:Registries; D013997:Time Factors