Social inequalities in perinatal mortality in a Southern European city

The objective of this study was to describe and explain inequalities in perinatal mortality by educational level and occupational social class in Barcelona for the years 1993-1997. This was a case-control study. Cases were singleton perinatal deaths, controls were singleton live births obtained from a 2% random sample of births. The association among educational level, social class, other confounding and explanatory variables and perinatal mortality was studied through crude and adjusted odds ratios (OR) obtained by logistic regression. The study comprised 423 cases and 1032 controls. The model with mother's age and educational level showed that women with primary education had an OR of 1.75 (95% CI: 1.26-2.42), this association disappearing when explanatory variables were included. We also found inequalities by educational level in fetal mortality. These results point out the need to improve the living conditions, behavioural factors and also the management of pregnancy, labour and the health care of the newborn of these mothers with greater risk.