[Social differences in the prenatal and postnatal mortality: Switzerland 1979-1985]

Determinants of stillbirth mortality in Greece

A population-based case-control study of the determinants of stillbirths was conducted in Greece from 1989 to 1991. All reported stillbirths after 28 weeks of pregnancy (N = 2,006) during the three year study period comprised the case group. The control group derived from random sampling of 10% of all livebirths in Greece, during the same period (N = 30,705). The data were analysed by modelling through multiple logistic regression. The adjusted relative risk of stillbirth was significantly higher for males compared to females. A statistically significant monotonic increase in relative risk was observed with shorter gestational age, low maternal education, and older maternal age. Birthweight and parity showed a statistically significant U-shaped association with stillbirth risk, with a higher risk being observed among both low and high birthweight deliveries, as well as among primiparous or multiparous (4+) mothers. Positive associations of stillbirth with multiple births, out-of-wedlock marriage and non-Greek-orthodox maternal religion were noted in crude analyses, but these associations almost disappeared in logistic regression model. Maternal urban or rural residence showed no relation to risk. Overall, the prospective risk of stillbirth after the 24th week of gestation in Greece has been estimated to be higher than that in Japan (a more developed country) with more than 40% of stillbirths occurring after the 36th week of pregnancy.

Socio-economic factors and mortality in Switzerland

This review paper is concerned with the topic of mortality differences by socio-economic group in Switzerland. After a short introduction to the topic and the pitfalls associated with it, the paper reviews work done in the course of a ten year programme investigating socio-economic mortality differentials in Switzerland. This programme was carried out by a working group at the Department of Social and Preventive Medicine of the University of Berne. The paper reviews methodological difficulties and pitfalls and relates the Swiss results to findings from other countries including England and Wales and Sweden. The disadvantages of socially isolated groups such as children of single women are shown. The relatively high mortality of groups under economic pressure, such as skilled manual workers in Switzerland, is demonstrated. The Swiss situation is interesting in that skilled manual workers have a higher mortality than the unskilled and semi-skilled groups. It is concluded that this is not an artifact but may be due to the fact that only Swiss workers were investigated and that Switzerland has a large proportion of foreign workers, especially in the less skilled groups. In addition, some results of an investigation of cancer mortality by occupation are reported too. Apart from some occupation-specific findings, there are some interesting cross-references to socio-economic differential mortality.