Gestational age specific stillbirth risk among Indigenous and non-Indigenous women in Queensland, Australia: a population based study

Ibiebele, Ibinabo, Coory, Michael, Smith, Gordon C., Boyle, Frances M., Vlack, Susan, Middleton, Philippa, Roe, Yvette and Flenady, Vicki (2016) Gestational age specific stillbirth risk among Indigenous and non-Indigenous women in Queensland, Australia: a population based study. BMC Pregnancy and Childbirth, 16 159: 1-8. doi:10.1186/s12884-016-0943-7


Author Ibiebele, Ibinabo
Coory, Michael
Smith, Gordon C.
Boyle, Frances M.
Vlack, Susan
Middleton, Philippa
Roe, Yvette
Flenady, Vicki
Title Gestational age specific stillbirth risk among Indigenous and non-Indigenous women in Queensland, Australia: a population based study
Journal name BMC Pregnancy and Childbirth   Check publisher's open access policy
ISSN 1471-2393
Publication date 2016-07-15
Year available 2016
Sub-type Article (original research)
DOI 10.1186/s12884-016-0943-7
Open Access Status DOI
Volume 16
Issue 159
Start page 1
End page 8
Total pages 8
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2017
Language eng
Formatted abstract
Background
In Australia, significant disparity persists in stillbirth rates between Aboriginal and Torres Strait Islander (Indigenous Australian) and non-Indigenous women. Diabetes, hypertension, antepartum haemorrhage and small-for-gestational age (SGA) have been identified as important contributors to higher rates among Indigenous women. The objective of this study was to examine gestational age specific risk of stillbirth associated with these conditions among Indigenous and non-Indigenous women.

Methods
Retrospective population-based study of all singleton births of at least 20 weeks gestation or at least 400 grams birthweight in Queensland between July 2005 and December 2011 using data from the Queensland Perinatal Data Collection, which is a routinely-maintained database that collects data on all births in Queensland. Multivariate logistic regression was used to calculate adjusted odds ratios (aOR) and 95 % confidence intervals, adjusting for maternal demographic and pregnancy factors.

Results
Of 360987 births analysed, 20273 (5.6 %) were to Indigenous women and 340714 (94.4 %) were to non-Indigenous women. Stillbirth rates were 7.9 (95 % CI 6.8–9.2) and 4.1 (95 % CI 3.9–4.3) per 1000 births, respectively. For both Indigenous and non-Indigenous women across most gestational age groups, antepartum haemorrhage, SGA, pre-existing diabetes and pre-existing hypertension were associated with increased risk of stillbirth. There were mixed results for pre-eclampsia and eclampsia and a consistently raised risk of stillbirth was not seen for gestational diabetes.

Conclusion
This study highlights gestational age specific stillbirth risk for Indigenous and non-Indigenous women; and disparity in risk at term gestations. Improving access to and utilisation of appropriate and responsive healthcare may help to address disparities in stillbirth risk for Indigenous women.
Keyword Aboriginal and Torres Strait Islander Australians
Indigenous
Fetal death
Stillbirth
Risk
Diabetes
Hypertension
Antepartum haemorrhage
Small for gestational age
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
HERDC Pre-Audit
School of Public Health Publications
 
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Created: Wed, 27 Jul 2016, 14:34:09 EST by Dr Fran Boyle on behalf of School of Public Health