Sue V Kildea1, Yu Gao2, Margaret Rolfe3, Jacqueline Boyle4, Sally Tracy5, Lesley M Barclay3. 1. School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Qld 4010, Australia; Mater Research Institute - The University of Queensland, Brisbane, Qld 4101, Australia. Electronic address: sue.kildea@mater.uq.edu.au. 2. School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Qld 4010, Australia; Mater Research Institute - The University of Queensland, Brisbane, Qld 4101, Australia. 3. University Centre for Rural Health North Coast, Sydney Medical School, University of Sydney, Lismore, NSW 2480, Australia. 4. Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 5. School of Nursing, University of Sydney, Sydney, NSW 2050, Australia.
Abstract
OBJECTIVE: To identify the risk factors for preterm birth, low birthweight and small for gestational age babies among remote-dwelling Aboriginal women. METHODS: The study included 713 singleton births from two large remote Aboriginal communities in Northern Territory, Australia in 2004-2006 (retrospective cohort) and 2009-2011 (prospective cohort). Demographic, pregnancy characteristics, labour and birth outcomes were described. Multivariate logistic regression analysis was conducted and adjusted odds ratios were reported. RESULTS: The preterm birth rate was 19.4%, low birthweight rate was 17.4% and small for gestational age rate was 16.3%. Risk factors for preterm birth were teenage motherhood, previous preterm birth, smoker status not recorded, inadequate antenatal visits, having pregnancy-induced hypertension, antepartum haemorrhage or placental complications. After adjusting for gender and birth gestation, the only significant risk factor for low birthweight was first time mother. The only significant risk factor for small for gestational age baby was women having their first baby. CONCLUSIONS: Rates of these events are high and have changed little over time. Some risk factors are modifiable and treatable but need early, high quality, culturally responsive women centred care delivered in the remote communities themselves. A different approach is recommended.
OBJECTIVE: To identify the risk factors for preterm birth, low birthweight and small for gestational age babies among remote-dwelling Aboriginal women. METHODS: The study included 713 singleton births from two large remote Aboriginal communities in Northern Territory, Australia in 2004-2006 (retrospective cohort) and 2009-2011 (prospective cohort). Demographic, pregnancy characteristics, labour and birth outcomes were described. Multivariate logistic regression analysis was conducted and adjusted odds ratios were reported. RESULTS: The preterm birth rate was 19.4%, low birthweight rate was 17.4% and small for gestational age rate was 16.3%. Risk factors for preterm birth were teenage motherhood, previous preterm birth, smoker status not recorded, inadequate antenatal visits, having pregnancy-induced hypertension, antepartum haemorrhage or placental complications. After adjusting for gender and birth gestation, the only significant risk factor for low birthweight was first time mother. The only significant risk factor for small for gestational age baby was women having their first baby. CONCLUSIONS: Rates of these events are high and have changed little over time. Some risk factors are modifiable and treatable but need early, high quality, culturally responsive women centred care delivered in the remote communities themselves. A different approach is recommended.
Authors: Jiayuan Hao; Faxue Zhang; Dieyi Chen; Yanyun Liu; Lina Liao; Cui Shen; Tianyu Liu; Jingling Liao; Lu Ma Journal: Environ Sci Pollut Res Int Date: 2019-09-06 Impact factor: 4.223