Maternal Asian ethnicity and obstetric intrapartum intervention: a retrospective cohort study

Reddy, Maya; Wallace, Euan M.; Mockler, Joanne C.; Stewart, Lynne; Knight, Michelle; Hodges, Ryan; Skinner, Sasha; Davies‐Tuck, Miranda

doi:10.1186/s12884-016-1187-2

Cited by 15 publications

(13 citation statements)

References 37 publications

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“…One team in Victoria demonstrated that, compared with Australian‐born women, East African maternal region of birth was associated with increased risk of perinatal death and some adverse perinatal outcomes 14 . Other Australian studies found an association between maternal region of birth and risk of obstetric intervention during birth 15,16 . Finally, another team in Victoria reported that late preterm births to South Asian‐born women were less likely to be admitted to the nursery and had better respiratory outcomes than those born to Australian/New Zealand‐born women 17 …”

Section: Introductionmentioning

confidence: 99%

“…14 Other Australian studies found an association between maternal region of birth and risk of obstetric intervention during birth. 15,16 Finally, another team in Victoria reported that late preterm births to South Asian-born women were less likely to be admitted to the nursery and had better respiratory outcomes than those born to Australian/New Zealand-born women. 17 Although this research provides important context, to date no studies have explored the relation between maternal region of birth and a broader composite indicator of neonatal morbidity comprising multiple components such as cerebral or respiratory conditions, need for respiratory support or intravenous fluids.…”

Section: Introductionmentioning

confidence: 99%

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Rates of neonatal morbidity by maternal region of birth and gestational age in New South Wales, Australia 2003‐2016

Berman

Ibiebele

Randall

et al. 2020

Acta Obstet Gynecol Scand

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Introduction Research suggests that neonatal morbidity differs by maternal region of birth at different gestational ages. This study aimed to determine the overall and gestation‐specific risk of neonatal morbidity by maternal region of birth, after adjustment for maternal, infant and birth characteristics, for women giving birth in New South Wales, Australia, from 2003 to 2016. Material and methods The study utilized a retrospective cohort study design using linked births, hospital and deaths data. Modified Poisson regression was used to determine risk with 95% confidence intervals (95% CI) of neonatal morbidity by maternal region of birth, overall and at each gestational age, compared with Australian or New Zealand‐born women giving birth at 39 weeks. Results There were 1 074 930 live singleton births ≥32 weeks’ gestation that met the study inclusion criteria, and 44 394 of these were classified as morbid, giving a neonatal morbidity rate of 4.13 per 100 live births. The gestational age‐specific neonatal morbidity rate declined from 32 weeks’ gestation, reaching a minimum at 39 weeks in all maternal regions of birth. The unadjusted neonatal morbidity rate was highest in South Asian‐born women at most gestations. Adjusted rates of neonatal morbidity between 32 and 44 weeks were significantly lower for babies born to East (adjusted relative risk [aRR] 0.65, 95% CI 0.62‐0.68), South‐east (aRR 0.76, 95% CI 0.73‐0.79) and West Asian‐born (aRR 0.93, 95% CI 0.88‐0.98) mothers, and higher for babies of Oceanian‐born (aRR 1.11, 95% CI 1.04‐1.18) mothers, compared with Australian or New Zealand‐born mothers. Babies of African, Oceanian, South Asian and West Asian‐born women had a lower adjusted risk of neonatal morbidity than Australian or New Zealand‐born women until 37 or 38 weeks’ gestation, and thereafter an equal or higher risk in the term and post‐term periods. Conclusions Maternal region of birth is an independent risk factor for neonatal morbidity in New South Wales.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rates of neonatal morbidity by maternal region of birth and gestational age in New South Wales, Australia 2003‐2016

Berman

Ibiebele

Randall

et al. 2020

Acta Obstet Gynecol Scand

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“…53,54 In general, Asian women have a lower BMI and have neonates with lower birth weights and fewer LGA infants than Caucasian women. 55,56 In contrast to these two previous studies, the current study presents data for a larger sample of 64 diabetic women, and outcomes are reported for women with GDM only, rather than combining potentially confounding results from women with GDM and pre-existing diabetes. We report data for a range of maternal and foetal characteristics, and analysed kidney size by assessing left and right kidney dimensions and volumes, as well as total kidney volume and total volume adjusted for foetal size.…”

Section: Discussionmentioning

confidence: 99%

Normal foetal kidney volume in offspring of women treated for gestational diabetes

Hokke

Zoysa

Carr

et al. 2019

Endocrino Diabet & Metabol

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Aims The worldwide prevalence of gestational diabetes mellitus (GDM) is increasing. Studies in rodent models indicate that hyperglycaemia during pregnancy alters kidney development, yet few studies have examined if this is so in humans. The objective of this study was to evaluate the association of treated GDM with foetal kidney size. Materials and Methods Participants were recruited from an Australian tertiary hospital, and clinical data were collected from women without GDM and women diagnosed and treated for GDM and their offspring. Participants underwent an obstetric ultrasound at 32‐34 weeks gestation for foetal biometry and foetal kidney volume measurement. Results Sixty‐four non‐GDM and 64 GDM women participated in the study. Thirty percent of GDM women were diagnosed with fasting hyperglycaemia, while 89% had an elevated 2‐hour glucose level. Maternal age, weight and body mass index were similar in women with and without GDM. Estimated foetal weight, foetal kidney dimensions, total foetal kidney volume and birth weight were similar in offspring of women with and without GDM. Conclusions We conclude that a period of mild hyperglycaemia prior to diagnosis of GDM and treatment initiation, which coincides with a period of rapid nephron formation and kidney growth, does not alter kidney size at 32‐34 weeks gestation.

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“…There is growing evidence to suggest that the higher rate of stillbirth at term in South Asian-born women is due to differences in pregnancy length and feto-placental maturation. South Asian women have, on average, a 1 week shorter duration of pregnancy (11), higher rates of fetal compromise in late pregnancy and during labour (16), and babies that are more functionally mature at preterm gestations (17). Re ecting these local insights, the maternity program at Monash Health sought to implement a simple change in clinical practice to reduce the rate of term stillbirth in South Asian women.…”

Section: Introductionmentioning

confidence: 99%

Understanding staff views and experiences of a clinical practice change to reduce stillbirth in South Asian born women: A cross-sectional survey

Davies‐Tuck

Ruzic

Davey

et al. 2020

Preprint

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Background: To capture the views and experiences of clinical staff following the implementation of a new clinical guideline aimed at reducing stillbirth at term in South Asian women, to identify barriers to implementation. Methods: Cross sectional survey of clinical staff providing maternity care, including midwives, obstetricians and shared-care general practitioner at a Victorian metropolitan university-affiliated teaching hospital caring for about 10,000 women per year at three separate hospital sites. Staff were asked to provide their agreement with ten statements assessing: perceived need for the guideline, implementation processes, guideline clarity, and clinical application. Two open-ended questions provided opportunities to express concerns and offer suggestions for improvement. Results: 120 staff completed the survey, the majority (n=89, 74%) of which were midwives. The majority of staff thought the guideline was clear with respect to the rationale (n=95, 79%,), the criteria for whom they applied (83%, n=99), and the procedures and instructions within the guideline were clear (74%, n=89). However, staff reported an increase in workload following the implementation of the guideline (72%, n=86) and expressed concerns related to rationale and evaluation of the guidelines, lack of education for staff and women, increased workload and insufficient resources, and patient safety and access to care. Challenges relating to shared decision making and communicating with women whose first language is not English were also identified. Conclusion: This assessment of staff views and experiences of a new clinical practice guideline has identified key barriers to and opportunities for improving implementation. It has also highlighted additional challenges relating to new clinical guidelines which focus on culturally and linguistically diverse (CALD) women.

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Maternal Asian ethnicity and obstetric intrapartum intervention: a retrospective cohort study

Cited by 15 publications

References 37 publications

Rates of neonatal morbidity by maternal region of birth and gestational age in New South Wales, Australia 2003‐2016

Rates of neonatal morbidity by maternal region of birth and gestational age in New South Wales, Australia 2003‐2016

Normal foetal kidney volume in offspring of women treated for gestational diabetes

Understanding staff views and experiences of a clinical practice change to reduce stillbirth in South Asian born women: A cross-sectional survey

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