P1-451 Infant mortality in Switzerland

Adverse perinatal outcomes among children in Switzerland: the impact of national origin and socio-economic group

OBJECTIVES

We examined the effect of the mother's origin and socio-economic characteristics on adverse perinatal outcomes in Switzerland.

METHODS

Births occurring from 2011 to 2017 were identified in the Swiss population register and merged with the Swiss civil register and the Register of the first pillar to obtain information on the migration origin and socio-economic level. Four indicators of adverse perinatal outcomes were defined.

RESULTS

Logistic regressions show that both the migration origin and the socio-economic level are measured by the parents' income, influence risk. Compared to the children of mothers born in Switzerland, those of mothers from EU/EFTA countries have a lower risk of infant mortality, low birth weight and extreme prematurity. The highest risk is observed for children born to mothers from the rest of the world. High levels of risk consistently characterize children with low-income parents (first decile).

CONCLUSIONS

Our results justify further investigations at the level of health services to better identify the factors causing differences in the prevalence of adverse outcomes and to take them into account in adapted health policies.

The contribution of the foreign population to the high level of infant mortality in Switzerland: a demographic analysis

BACKGROUND

In 2011 Switzerland reported the highest infant mortality rate among Western European countries, as well as the highest percentage of foreign population (23%). The comparison of the Swiss and foreign population in terms of reproductive health has received so far insufficient attention. The aim of the present study is to analyze the infant (IMR) and neonatal mortality rates (NMR) of Swiss and foreign children over the last 30 years.

METHODS

Vital statistics from the period 1980 to 2011 were used to compute IMR and NMR according to year and/or citizenship. The main analyses were made contrasting Swiss versus foreigners as a single category, as well as by country of origin. Comparisons between groups were done using relative risks.

RESULTS

In 1980-1989, IMR was 14% higher among foreign children as compared to Swiss children, and NMR 28% higher. In 2006-2010, IMR was 18% higher among foreign children than among Swiss children, and NMR 29% higher. The highest gap of IMR was observed during the period 1990-1993 (+21%). Looking at single countries, in 2008-2010 children of migrants from Germany, Portugal, Turkey, Italy, France, Kosovo and Spain had a higher level of IMR as compared to Swiss children.

CONCLUSIONS

The analysis of vital statistics confirms that over the last 30 years the gap of IMR and NMR between Swiss and foreign children has not decreased. Whatever the combination of mechanisms, which cause the observed difference, this fundamental inequity needs to be investigated and remedied by a large scale, concerted effort.