Abstract
In a study of perinatal mortality and birthweight in a multiracial population attending Dudley Road Hospital, Birmingham, a higher perinatal mortality rate was noted in the Indian and Pakistani populations and a lower birthweight in the Indian, Pakistani, and West Indian populations when compared with Europeans. The recognisable socio-cultural features which differentiate ethnic groups, make comparison difficult.
In Indians and Pakistanis there were slightly increased normally formed neonatal death and stillbirth rates but significantly higher congenital abnormality rates were the most noticable features in these two groups. Alimentary abnormality, and in particular gut atresia, occur red in Indians with no obvious aetiological factors. Multiple and chromosomal abnormality was a feature of Pakistanis, possibly associated with increased maternal age and consanguinity. An improved survival rate of neonates of very low birthweight and short gestation in West Indians was also noted.
The differences in birthweight seemed to be a physiological feature of the ethnic groups studied rather than associated with any increase in pathology that might lead to a reduction in birthweight except, perhaps, in the Indian group where there was also a reduction in the ponderal index suggestive of a higher incidence of intrauterine growth retardation. In fact birthweight in Europeans seemed more sensitive to variation, there being a reduction in smokers not associated with a reduction in the ponderal index, and a reduction in European mothers who failed to gain weight that was associated with a reduction in the ponderal index suggestive of intrauterine growth retardation.
Studies on neonatal survival, the birthweight/gestation growth curve, and gestation alone all indicated that term was not the same in all ethnic groups, being around 40 weeks in Europeans but somewhat shorter in the other groups and, especially in West Indians, it is suggested that physiological maturity of a fetus occurs at an earlier gestation compared with the European population.
The evidence presented in this study demonstrated that the obstetric problems of ethnic minority groups are specific to a particular group and, although associated with social disadvantage, are unlikely to be helped by general measures. Rather, specific remedies should be directed at groups who can be shown to be at increased risk of a specific condition.
