1. Objectifs

Intentions :
«[D]isparities in preterm birth and delayed fetal growth are rising between Haitian and non-Haitian Canadians. [...] These alarming findings warrant more study of trends in stillbirth for Haitians. We sought to determine rates of stillbirth for Haitians by gestational interval in Quebec, home to 90% of Canadian Haitians.» (p. 333)

2. Méthode

Échantillon/Matériau :
«We analysed singleton livebirth (n = 2 482 364) and stillbirth (n = 10 287) registration certificates in Quebec from 1981 to 2010.» (p. 333)

Type de traitement des données :
Analyse statistique

3. Résumé

«This study shows that inequalities in stillbirth are present in Canada between Haitians and non-Haitians. The gap widened at 32–36 weeks of gestation before stabilising, and rates were higher for Haitians who use Creole at home than Haitians who use French/English. Thus, opportunities for prevention may exist by targeting the late preterm period, and social factors sensitive to culture or access to care, which may vary depending on acculturation. […] It is surprising, however, that Haitians who use Creole at home have higher stillbirth rates than Canadian Inuit (8.1 vs. 6.8 per 1000, excluding stillbirths below 24 gestational weeks). Access to health care is greater in urban areas where the majority of Haitians reside, unlike Aboriginals who tend to live in remote areas. Researchers have proposed that barriers in access in the US contribute to Black–White stillbirth inequality, but health care is funded publicly for residents and documented migrants in Quebec. There is, however, evidence that Haitians underuse health care services in Quebec or rely on alternative health practitioners. Communication or cultural barriers to access may also exist, as Haitians who use Creole at home have higher stillbirth rates than Haitians who use French or English.» (p. 335)