Perinatal dødelighet blant etniske minoritetsgrupper i Norge

Abstract

Abstract

The Norwegian society has become multicultural, and during the last decades the immigrant population in Norway has grown. Immigrants constitute today about 25% of the population in Oslo, and about 80% of the immigrant population in Oslo come from the third world. This situation brings new challenges for the medical service in Norway. In the world’s poorest countries between 10 and 20 % of the infants die during their first year of life, and perinatal and infant death represent huge social, economical and political challenges. This literature study is a part of the medical study at the University of Oslo. I have studied previous published scientific studies which survey the perinatal death-rate among ethnic minority groups in Norway compared to the death-rate among ethnic Norwegians. The perinatal death rates among ethnic minority groups varies among different groups, and depends among other things of ethnic origin and a higher occurrence of specific risk factors in some ethnic groups. Some of these risk factors are well documented. Both the prevalence of pregestational and gestational diabetes is higher among some ethnic minority groups in Norway, for instance among immigrants from South Asia and North Africa. Studies from Norway and foreign countries have showed that maternal diabetes is associated with a considerably increased risk of adverse birth outcomes, including low birth weight, macrosomia, preterm birth, preeclampsia and cesarean section. It is also showed that consanguinity, which is common among immigrants from Asia and Africa, increases the risk of birth defects, stillbirth and infant death. Studies have also showed that sub-optimal medical care during pregnancy and delivery, which may lead to potentially avoidable deaths, is more common among non-western immigrants than among ethnic Norwegians. In a Swedish study 63 % of the perinatal deaths among immigrants from Eritrea, Somalia and Ethiopia were classified as potentially avoidable. Among Swedish’s 11 % of the intra partum deaths were classified similarly. On the other hand, more research is necessary in many multicultural fields. There are reasons to believe that some aspects of the health of some ethnic minority groups may have a negative effect on the perinatal outcome, for instance genital mutilation, some haematological conditions, caesarean section and infections.