TY - JOUR
T1 - Trends in maternal and newborn health characteristics and obstetric interventions among Aboriginal and Torres Strait Islander mothers in Western Australia from 1986 to 2009
AU - Diouf, Ibrahima
AU - Gubhaju, Lina
AU - Chamberlain, Catherine
AU - McNamara, Bridgette
AU - Joshy, Grace
AU - Oats, Jeremy
AU - Stanley, Fiona
AU - Eades, Sandra
N1 - Publisher Copyright:
© 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Background Detailed analyses of long-term trends in Aboriginal maternal and newborn health characteristics are lacking. Aim To examine trends in maternal and newborn health characteristics for all mothers who were recorded as Aboriginal in the Western Australian Midwives' Notification System from 1986 to 2009. Materials and Methods Births were categorised into four-year time intervals (1986-1989, 1990-1993, 1994-1997, 1998-2001, 2002-2005, 2006-2009). Trends in maternal demographic characteristics, pre-existing medical conditions, pregnancy complications and neonatal characteristics were examined. Results For 37 424 births recorded from 1986 to 2009, the proportion of births to mothers aged ≤19 years decreased (31-22%, P < 0.001) along with the prevalence of pre-eclampsia (6.8-4.0%, P < 0.001) and antepartum haemorrhage (4.8-3.2%, P < 0.001). There were increases in the prevalence of diabetes in pregnancy (3.8-6.6%, P < 0.001), induction of labour (17.8-21.4%, P < 0.001), elective caesarean (6.6-8.2%, P < 0.001) and emergency caesarean (9.5-14.9%, P < 0.001) deliveries. There were no changes in the overall prevalence of preterm births (15.4-15.9%, P = 0.32). However, increases were observed in the prevalence of medically indicated preterm births with and without prelabour rupture of membranes (1.0-1.7%; P < 0.001 and 3.3-4.3%; P = 0.005, respectively). There were no significant changes in the rates of smoking during pregnancy (51-52% from 1998 to 2009, P = 0.18), small-for-gestational age (16.9-17.2%, P = 0.07), suboptimal-birthweight (20.4-20.1%, P = 0.92), stillbirths (14.7 per 1000-12.1 per 1000, P = 0.22) and neonatal deaths (6.2 per 1000-5.5 per 1000, P = 0.68). Conclusion Encouraging trends include reduced rates of teenage pregnancy, pre-eclampsia and antepartum haemorrhage. The persistent high rates of smoking during pregnancy, preterm births, stillbirths, neonatal deaths and increasing rates of diabetes in pregnancy are of concern.
AB - Background Detailed analyses of long-term trends in Aboriginal maternal and newborn health characteristics are lacking. Aim To examine trends in maternal and newborn health characteristics for all mothers who were recorded as Aboriginal in the Western Australian Midwives' Notification System from 1986 to 2009. Materials and Methods Births were categorised into four-year time intervals (1986-1989, 1990-1993, 1994-1997, 1998-2001, 2002-2005, 2006-2009). Trends in maternal demographic characteristics, pre-existing medical conditions, pregnancy complications and neonatal characteristics were examined. Results For 37 424 births recorded from 1986 to 2009, the proportion of births to mothers aged ≤19 years decreased (31-22%, P < 0.001) along with the prevalence of pre-eclampsia (6.8-4.0%, P < 0.001) and antepartum haemorrhage (4.8-3.2%, P < 0.001). There were increases in the prevalence of diabetes in pregnancy (3.8-6.6%, P < 0.001), induction of labour (17.8-21.4%, P < 0.001), elective caesarean (6.6-8.2%, P < 0.001) and emergency caesarean (9.5-14.9%, P < 0.001) deliveries. There were no changes in the overall prevalence of preterm births (15.4-15.9%, P = 0.32). However, increases were observed in the prevalence of medically indicated preterm births with and without prelabour rupture of membranes (1.0-1.7%; P < 0.001 and 3.3-4.3%; P = 0.005, respectively). There were no significant changes in the rates of smoking during pregnancy (51-52% from 1998 to 2009, P = 0.18), small-for-gestational age (16.9-17.2%, P = 0.07), suboptimal-birthweight (20.4-20.1%, P = 0.92), stillbirths (14.7 per 1000-12.1 per 1000, P = 0.22) and neonatal deaths (6.2 per 1000-5.5 per 1000, P = 0.68). Conclusion Encouraging trends include reduced rates of teenage pregnancy, pre-eclampsia and antepartum haemorrhage. The persistent high rates of smoking during pregnancy, preterm births, stillbirths, neonatal deaths and increasing rates of diabetes in pregnancy are of concern.
KW - Aboriginal
KW - Western Australia
KW - health
KW - mothers
KW - newborn
UR - http://www.scopus.com/inward/record.url?scp=84949266409&partnerID=8YFLogxK
U2 - 10.1111/ajo.12416
DO - 10.1111/ajo.12416
M3 - Article
SN - 0004-8666
VL - 56
SP - 245
EP - 251
JO - Australian and New Zealand Journal of Obstetrics and Gynaecology
JF - Australian and New Zealand Journal of Obstetrics and Gynaecology
IS - 3
ER -