Introduction: Racial disparities in adverse perinatal outcomes have been well documented in other countries, however, little is known for Canadian population. Our study aims to examine the differences in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada.
Methods: We conducted a population-based retrospective cohort study among Asian and Caucasian women who had perinatal screening with a singleton birth in an Ontario hospital between 2016 and 2017. Occurrences of adverse perinatal outcomes were examined in Asians and Caucasians, separately. Log-binomial regression models were used to estimate the relative risks (RRs) and 95% confidence intervals (CIs) of adverse perinatal outcomes between Asians and Caucasians.
Results: Among 69,734 eligible women, 31.3% were Asians and 68.7% were Caucasians. Compared to Caucasian women, Asian women had higher risks of gestational diabetes (13.7% vs 5.7%, RR 2.42, 95% CI [2.30-2.54]), 3rd and 4th degree perineal tears (5.3% vs 3.4%, RR 1.38, 95% CI [1.38-1.64]), low birth weight (less than 2500g, 6.5% vs 4.1%, RR 1.57, 95% CI [1.46-1.67]), small-for-gestational-age neonates (less than 10th percentile, 14.2% vs 7.7%, RR 1.84, 95% CI [1.76-1.92]), and preterm birth (gestational age less than 37 weeks, 6. 3% vs 5.8%, RR 1.09, 95% CI [1.02-1.16]); but had lower risks of preeclampsia (0.6% vs 1.2%, RR 0.53, 95% CI [0.44-0.64]), macrosomia (birth weight greater than 4000g, 4.7% vs 12.0%, RR 0.39, 95% CI [0.37-0.42]), and large-for-gestational-age neonates (greater than 90th percentile, 5.1% vs 11.2%, RR 0.46, 95% CI [0.43-0.48]). We found no significant differences in risk of caesarean section, stillbirth, neonatal death, and neonatal intensive care unit admission between Asians and Caucasians.
Conclusion: Our population-based study reveals significant differences in several adverse perinatal outcomes between Asians and Caucasians within the universal health care system. These differences should be taken into consideration for clinical practices due to large Asian populations in Canada.
Daniel Corsi– Adjunct Professor, School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Canada
Shi Wu Wen– Professor and Senior Scientist, School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Canada
Yanfang Guo– Adjunct Professor and Epidemiologist, School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, ON, CA