Indigenous birth outcomes at a Victorian urban hospital, a retrospective 5-year cohort study 2010-2014

Whish-Wilson, Thomas; Tacey, Mark; McCarthy, Elizabeth; Howat, Paul

doi:10.1111/ajo.12439

Cited by 10 publications

(11 citation statements)

References 15 publications

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“…A similar retrospective cohort study was recently conducted in a non-tertiary Melbourne hospital, which concluded similar rates of low birthweight to Aboriginal and non-Aboriginal parents [ 25 ]. This discrepancy may firstly be due to differences in defining Aboriginal status, where maternal and paternal Aboriginal status was recorded on one database and the ethnicity of the baby was allocated if either parent was Aboriginal.…”

Section: Discussionmentioning

confidence: 85%

Pregnancy risk factors associated with birthweight of infants born to Australian Aboriginal women in an urban setting - a retrospective cohort study

Ford

Cade

Doyle

et al. 2018

BMC Pregnancy Childbirth

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BackgroundA key focus of the Closing the Gap campaign is to reduce low birthweight in Aboriginal babies. Limited research exists on factors affecting Aboriginal birthweight in urban areas.MethodsRetrospective cohort analysis of 38,382 births (38,167 non-Aboriginal, 215 Aboriginal) at the Royal Women’s Hospital in Melbourne from January 2010 to December 2015. Aboriginal status was defined by mothers who identified themselves and their baby as Aboriginal or Torres Strait Islander. The aim was to examine the association of maternal health risk behaviours and obstetric complications with birthweight of infants born to Australian Aboriginal women birthing in an urban setting.ResultsAboriginal babies had a lower mean birthweight than non-Aboriginal babies (mean difference -290 g; 95% confidence interval [CI] -413, − 166 g), but when accounting for gestational age and sex there was little difference (mean difference 5 g; 95% CI -53, 6 g). Aboriginal babies were significantly more likely to be delivered preterm < 37 weeks (23.3% vs 7.9%, odds ratio [OR] 3.58; 95% CI 2.58, 4.95) and be of low birthweight < 2500 g (22.3% vs 6.7%, OR 4.03; 95% CI 2.90, 5.60) or very low birthweight < 1500 g (9.8% vs 1.8%, OR 5.81; 95% CI 3.67, 9.16).Aboriginal mothers were significantly more likely to be teenage mothers (9.8% vs 1.6%, OR 5.72; 95% CI 3.54, 9.24), smoke cigarettes throughout the pregnancy (53.8% vs 5.6%, OR 17.2; 95% CI 12.8, 23.0), and use drugs (26.5% vs 2.4%, OR 14.3; 95% CI 10.4, 19.6) during pregnancy, all of which were associated with lower birthweight. Aboriginal mothers were also more likely to have a mental health diagnosis (49.5% vs 18.8%, OR 3.77; 95% CI 2.86, 4.97), be overweight (59.9% vs 42.6%, OR 1.88; 95% CI 1.39, 2.56) and have diabetes (15.3% vs 7.3%, OR 2.31; 95% CI 1.59, 3.35) which were all associated with higher birthweight.ConclusionsAboriginal babies born in metropolitan Melbourne are more likely to be of low birthweight compared with non-Aboriginal babies, which in turn was related to higher rates of prematurity and not to being small for gestational age.

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Section: Discussionmentioning

confidence: 85%

Pregnancy risk factors associated with birthweight of infants born to Australian Aboriginal women in an urban setting - a retrospective cohort study

Ford

Cade

Doyle

et al. 2018

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

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“…Indigenous women bear a higher burden of diabetes in pregnancy in Australia and elsewhere . About 4% of Australians identify as indigenous, varying from region to region: around 1% in Victoria, more than one in four in the Northern Territory and more than one in two in the Cape York region of Far North Queensland . Rural‐remote compared with urban domicile appears to confer additional health risks for Aboriginal infants born to mothers with diabetes in pregnancy …”

Section: Resultsmentioning

confidence: 99%

Pregnancy outcomes for women with pre‐pregnancy diabetes mellitus in Australian populations, rural and metropolitan: A review

McCarthy

Williamson

Shub

2018

Aust NZ J Obst Gynaeco

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Background Historically, pre‐pregnancy diabetes (PPDM) is a recognised risk factor for poor pregnancy outcome. Co‐existing pathology and adverse social determinants including rural‐metropolitan inequities in health and healthcare access may confer additional risks. Multidisciplinary care before, during and after pregnancy can improve outcomes for women with PPDM and their infants. The extent to which rural Australian women and their families share in improved outcomes is unknown. We aimed to summarise maternal characteristics and pregnancy outcomes for women with PPDM, including women in rural settings and examine applications of existing clinical guidelines to rural Australian practice. Methods We sought English language population and cohort studies about PPDM using Medline, Embase, PubMed, Australian epidemiological and international clinical practice guidelines. Results Women with PPDM are changing: older, more obese, of lower parity, less likely to smoke, more likely to have type 2 rather than type 1 diabetes and shorter duration of PPDM. Women with PPDM continue to experience excess adverse pregnancy outcomes, including maternal morbidity, complicated birth, perinatal loss, congenital anomalies and mother‐infant separation. On face value, clinical guidelines appear relevant to women living in rural settings but there are only a few, conflicting outcome studies for rural women with PPDM. Conclusions PPDM is changing. A significant minority live in rural locations, and although perinatal mortality/morbidity seems to be improving, it is unclear if this is also true for rural women due to a lack of recent Australian studies. Further research is necessary to achieve excellence everywhere for women with PPDM and their babies.

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“…First Nations pregnant women face a double burden of malnutrition, with both macronutrient undernutrition and overnutrition detected more commonly when compared to non‐Indigenous women 19,52‐54 52 .…”

Section: Risk Factors For Ptb In First Nations Womenmentioning

confidence: 99%

A better start to life: Risk factors for, and prevention of, preterm birth in Australian First Nations women – A narrative review

Brown

Langston-Cox

Unger

2021

Intl J Gynecology & Obste

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The unacceptable discrepancies in health outcomes between First Nations and non‐Indigenous Australians begin at birth. Preterm birth (birth before 37 completed weeks of gestation) is a major contributor to adverse short‐ and long‐term health outcomes and mortality. Australian First Nations infants are more commonly born too early. No tangible reductions in preterm births have been made in First Nations communities. Factors contributing to high preterm birth rates in Australian First Nations infants are reviewed and interventions to reduce preterm birth in Australian First Nations women are discussed. More must be done to ensure Australian First Nations infants get a better start to life. This can only be achieved with ongoing and improved research in partnership with Australian First Nations peoples.

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Indigenous birth outcomes at a Victorian urban hospital, a retrospective 5-year cohort study 2010-2014

Cited by 10 publications

References 15 publications

Pregnancy risk factors associated with birthweight of infants born to Australian Aboriginal women in an urban setting - a retrospective cohort study

Pregnancy risk factors associated with birthweight of infants born to Australian Aboriginal women in an urban setting - a retrospective cohort study

Pregnancy outcomes for women with pre‐pregnancy diabetes mellitus in Australian populations, rural and metropolitan: A review

A better start to life: Risk factors for, and prevention of, preterm birth in Australian First Nations women – A narrative review

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