International Journal of Epidemiology, Volume 33, Number 1, pp. 107-113
IJE vol.33 no.1 © International Epidemiological Association 2004; all rights reserved.
Special Theme: Perinatal and early-life influences on disease |
Does gestation vary by ethnic group? A London-based study of over 122 000 pregnancies with spontaneous onset of labour
1 Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, Keppel St, London WC1E 7HT, UK
2 Current affiliation: Department of Obstetrics and Gynaecology, St Michael's Hospital, Southwell Street, Bristol BS2 8EG, UK
3 Academic Department of Obstetrics and Gynaecology, Imperial College Faculty of Medicine, Chelsea and Westminster Hospital, London SW10 9NH, UK
4 Department of Epidemiology and Public Health, Imperial College Faculty of Medicine, Norfolk Place, London W2 1PG, UK
Correspondence: Dr Roshni R Patel, Level D, Department of Obstetrics and Gynaecology, St Michael's Hospital, Southwell Street, Bristol BS2 8EG, UK. E-mail: roshni.patel{at}bristol.ac.uk
Background Evidence exists that normal gestational length varies with ethnicity. This UK-based study compares gestational length amongst a cohort of white European, Black and Asian women.
Methods The cohort comprised 122 415 nulliparous women with singleton live fetuses at the time of spontaneous labour, giving birth in the former North West Thames Health Region, London, UK.
Results The median gestational age at delivery was 39 weeks in Blacks and Asians and 40 weeks in white Europeans. Black women with normal body mass index (BMI) (18.5–24.9 kg/m2) had increased odds of preterm delivery (odds ratio [OR] = 1.33, 95% CI: 1.15, 1.56, adjusted for deprivation and BMI) compared with white Europeans. The OR of preterm delivery was also increased in Asians compared with white Europeans (OR = 1.45, 95% CI: 1.33, 1.56, adjusted for single unsupported status and smoking). Meconium stained amniotic fluid, which is a sign of fetal maturity, was statistically significantly more frequent in preterm Black and Asian infants and term Black infants compared with white European infants.
Conclusions This research suggests that normal gestational length is shorter in Black and Asian women compared with white European women and that fetal maturation may occur earlier.
Keywords Ethnicity, gestational length, St Mary's Maternity Information system (SMMIS), meconium, neonatal maturity
Accepted 14 May 2003
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