Obstetric Outcomes in an Aboriginal Community: A Comparison With the Surrounding Rural Area

Abstract

Antenatal, intranatal and postnatal features of all Aboriginal women who lived at Cherbourg Aboriginal Community and delivered during 1990, 1991 and 1992 were compared with all non-Aboriginal women in the same rural area who delivered at Kingaroy Base Hospital during 1991. Almost all the Aboriginal women also delivered at Kingaroy. The data for 146 Aboriginal and 139 non-Aboriginal women were taken from the hospital records. The Aboriginal women were generally younger at delivery (Aboriginal 35% younger than 20 years vs non-Aboriginal 12%), made their first antenatal visit later (Aboriginal 49% after 20 weeks vs non-Aboriginal 10%) and made fewer antenatal visits (Aboriginal 43% < 4 visits vs non-Aboriginal 2% < 4 visits). They were more likely to be anaemic (Aboriginal 65% < 110 g/L vs non-Aboriginal 13% < 110 g/L), have a sexually transmitted disease (STD; Aboriginal 13% vs non-Aboriginal 2%) and drink alcohol (Aboriginal 54% vs non-Aboriginal 32%). After making an allowance for repeat Caesarean sections, there was no significant difference in the proportion of abnormal deliveries, but birthweights of Aboriginal infants were lower. Postnatally, the only significant difference between the two groups was a lower incidence of jaundice in Aboriginal infants. Multifactorial analysis showed that birthweights were significantly decreased by primagravidy, alcohol intake and STD. It is likely that the effects of STD and alcohol on birthweight were due to associated lifestyle factors. When these factors were allowed for, ethnic background had no significant effect on birthweight.

Stillbirth rates among Indigenous and non‐Indigenous women in Queensland, Australia: is the gap closing?

“…This finding is somewhat consistent with several studies that found high rates of sexually transmitted infections (STIs) among Indigenous women of reproductive age living in rural communities 37,38 and pregnant Indigenous women living in urban areas. 39 Early diagnosis and treatment of syphilis has been shown to be associated with similar risk of stillbirth as the general uninfected population.…”

‘Choice, culture and confidence’: key findings from the 2012 having a baby in Queensland Aboriginal and Torres Strait Islander survey

“…The survey did not attempt to capture clinical data, nor did it measure a number of lifestyle factors known to contribute to poor perinatal health outcomes in Indigenous populations. These data are available elsewhere [79-81] and were not the focus of this study. Rather, the focus of this study was to investigate how maternity care was evaluated by Aboriginal and/or Torres Strait Islander women to inform improvements in service delivery.…”

Preventing stillbirths: Better data to inform interventions in Australia

“…This finding is supported by several studies that 86 found high rates of sexually transmitted infections (STIs) among Indigenous women of reproductive age living in rural communities [217,218] and pregnant Indigenous women living in urban areas [219]. Similarly, a population based study in Western Australia found infection to be an important cause of death for Indigenous infants [220].…”

“…217 The aetiology of stillbirth is varied, however, placental dysfunction has been suggested an important pathway [326] in the development of pre-eclampsia/eclampsia, fetal growth restriction and placental abruption [252]. Further research into the aetiology of placental dysfunction resulting in fetal death at later gestational ages could be useful in addressing the large proportion of term stillbirths with unknown cause of death.…”