Pregnancy outcomes in urban Aboriginal women

Caroline M De Costa · Andrew Child

80 citations0/0 files storedThe Medical Journal of Australia

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Indigenous Health, Education, and Rights Maternal and Neonatal Healthcare Indigenous Health and Education

Abstract

OBJECTIVE: To assess Aboriginal women's access to antenatal care and their pregnancy outcomes in an urban setting. DESIGN: Retrospective descriptive study using an obstetric database. SETTING: King George V Memorial Hospital, Sydney. PATIENTS: All women who gave birth between 1 January 1992 and 31 December 1993. OUTCOME MEASURES: Age and parity, gestation at first antenatal visit and at delivery, antenatal complications, type of delivery, infant birthweights and perinatal mortality were compared between Aboriginal and non-Aboriginal women. Within the Aboriginal group, comparisons were made between those with and without poor pregnancy outcomes (low birthweight infants and perinatal deaths). RESULTS: Aboriginal women were younger and of higher parity than non-Aboriginal women and booked for confinement later in pregnancy, although nearly 80% were booked by 28 weeks' gestation. There was more pregnancy-induced hypertension (P < 0.01; relative risk [RR], 1.66; 95% confidence interval [Cl], 1.17-2.37), urinary tract infection (P < 0.02; RR, 2.45; 95% Cl, 1.27-4.30) and need for methadone stabilisation in Aboriginal women (P < 0.001; RR, 5.88; 95% Cl, 2.99-11.57). In the Aboriginal group, there were higher preterm delivery rates (P < 0.001; 95% Cl, 1.31-2.74), more low birthweight babies (P < 0.001; 95% Cl, 1.67-3.33) and higher perinatal mortality rates. These findings applied to both Aboriginal women transferred from metropolitan district and country hospitals and those resident in central Sydney. Factors associated with low birthweight and perinatal deaths in Aboriginal infants included late antenatal booking, cigarette smoking, hypertension and urinary tract infection in pregnancy, and antepartum haemorrhage. CONCLUSION: Further efforts must be made to improve access of Aboriginal women to antenatal services in the Central Sydney Area to improve perinatal outcomes and maternal health.

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2006Bringing Safety and Responsiveness Into the Forefront of Care for Pregnant and Parenting Aboriginal People 2004Health outcomes in Aboriginal populations 2017Paths to improving care of Australian Aboriginal and Torres Strait Islander women following gestational diabetes 2008Bibbulung Gnarneep (‘solid kid’): Causal pathways to poor birth outcomes in an urban Aboriginal birth cohort 2007‘Making a Difference’: A New Care Paradigm for Pregnant and Parenting Aboriginal People 1999OBSTETRIC OUTCOMES IN AN ABORIGINAL COMMUNITY: A COMPARISON WITH THE SURROUNDING RURAL AREA 2018A history of health services for Aboriginal and Torres Strait Islander people 2016Improving Access to Antenatal Care for Aboriginal Women in South Australia: Evidence from a Population‐Based Study

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