A large proportion of poor birth outcomes among Aboriginal Western Australians are attributable to smoking, alcohol and substance misuse, and assault

Background: Aboriginal infants have poorer birth outcomes than non-Aboriginal infants. Harmful use of tobacco, alcohol, and other substances is higher among Aboriginal women, as is violence, due to factors such as intergenerational trauma and poverty. We estimated the proportion of small for gestati...

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Main Authors: Gibberd, A.J., Simpson, J.M., Jones, J., Williams, Robyn, Stanley, F., Eades, Sandra
Format: Journal Article
Language:English
Published: BMC 2019
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/91262
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author Gibberd, A.J.
Simpson, J.M.
Jones, J.
Williams, Robyn
Stanley, F.
Eades, Sandra
author_facet Gibberd, A.J.
Simpson, J.M.
Jones, J.
Williams, Robyn
Stanley, F.
Eades, Sandra
author_sort Gibberd, A.J.
building Curtin Institutional Repository
collection Online Access
description Background: Aboriginal infants have poorer birth outcomes than non-Aboriginal infants. Harmful use of tobacco, alcohol, and other substances is higher among Aboriginal women, as is violence, due to factors such as intergenerational trauma and poverty. We estimated the proportion of small for gestational age (SGA) births, preterm births, and perinatal deaths that could be attributed to these risks. Methods: Birth, hospital, mental health, and death records for Aboriginal singleton infants born in Western Australia from 1998 to 2010 and their parents were linked. Using logistic regression with a generalized estimating equation approach, associations with birth outcomes and population attributable fractions were estimated after adjusting for demographic factors and maternal health during pregnancy. Results: Of 28,119 births, 16% of infants were SGA, 13% were preterm, and 2% died perinatally. 51% of infants were exposed in utero to at least one of the risk factors and the fractions attributable to them were 37% (SGA), 16% (preterm) and 20% (perinatal death). Conclusions: A large proportion of adverse outcomes were attributable to the modifiable risk factors of substance use and assault. Significant improvements in Aboriginal perinatal health are likely to follow reductions in these risk factors. These results highlight the importance of identifying and implementing risk reduction measures which are effective in, and supported by, Aboriginal women, families, and communities.
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spelling curtin-20.500.11937-912622024-04-19T08:10:34Z A large proportion of poor birth outcomes among Aboriginal Western Australians are attributable to smoking, alcohol and substance misuse, and assault Gibberd, A.J. Simpson, J.M. Jones, J. Williams, Robyn Stanley, F. Eades, Sandra Science & Technology Life Sciences & Biomedicine Obstetrics & Gynecology Birthweight Preterm birth Perinatal mortality Aboriginal and Torres Strait Islander Australians Indigenous Linked routinely-collected data GESTATIONAL-AGE USE DISORDERS PREGNANCY RISK PREVALENCE WOMEN INTERVENTIONS PREDICTORS STILLBIRTH PATTERNS Aboriginal and Torres Strait Islander Australians Birthweight Indigenous Linked routinely-collected data Perinatal mortality Preterm birth Adult Domestic Violence Female Humans Infant, Newborn Infant, Small for Gestational Age Logistic Models Perinatal Death Pregnancy Pregnancy Complications Pregnancy Outcome Premature Birth Risk Factors Smoking Substance-Related Disorders Western Australia Humans Pregnancy Complications Premature Birth Substance-Related Disorders Pregnancy Outcome Logistic Models Risk Factors Smoking Pregnancy Domestic Violence Adult Infant, Newborn Infant, Small for Gestational Age Western Australia Female Perinatal Death Background: Aboriginal infants have poorer birth outcomes than non-Aboriginal infants. Harmful use of tobacco, alcohol, and other substances is higher among Aboriginal women, as is violence, due to factors such as intergenerational trauma and poverty. We estimated the proportion of small for gestational age (SGA) births, preterm births, and perinatal deaths that could be attributed to these risks. Methods: Birth, hospital, mental health, and death records for Aboriginal singleton infants born in Western Australia from 1998 to 2010 and their parents were linked. Using logistic regression with a generalized estimating equation approach, associations with birth outcomes and population attributable fractions were estimated after adjusting for demographic factors and maternal health during pregnancy. Results: Of 28,119 births, 16% of infants were SGA, 13% were preterm, and 2% died perinatally. 51% of infants were exposed in utero to at least one of the risk factors and the fractions attributable to them were 37% (SGA), 16% (preterm) and 20% (perinatal death). Conclusions: A large proportion of adverse outcomes were attributable to the modifiable risk factors of substance use and assault. Significant improvements in Aboriginal perinatal health are likely to follow reductions in these risk factors. These results highlight the importance of identifying and implementing risk reduction measures which are effective in, and supported by, Aboriginal women, families, and communities. 2019 Journal Article http://hdl.handle.net/20.500.11937/91262 10.1186/s12884-019-2252-4 English http://creativecommons.org/licenses/by/4.0/ BMC fulltext
spellingShingle Science & Technology
Life Sciences & Biomedicine
Obstetrics & Gynecology
Birthweight
Preterm birth
Perinatal mortality
Aboriginal and Torres Strait Islander Australians
Indigenous
Linked routinely-collected data
GESTATIONAL-AGE
USE DISORDERS
PREGNANCY
RISK
PREVALENCE
WOMEN
INTERVENTIONS
PREDICTORS
STILLBIRTH
PATTERNS
Aboriginal and Torres Strait Islander Australians
Birthweight
Indigenous
Linked routinely-collected data
Perinatal mortality
Preterm birth
Adult
Domestic Violence
Female
Humans
Infant, Newborn
Infant, Small for Gestational Age
Logistic Models
Perinatal Death
Pregnancy
Pregnancy Complications
Pregnancy Outcome
Premature Birth
Risk Factors
Smoking
Substance-Related Disorders
Western Australia
Humans
Pregnancy Complications
Premature Birth
Substance-Related Disorders
Pregnancy Outcome
Logistic Models
Risk Factors
Smoking
Pregnancy
Domestic Violence
Adult
Infant, Newborn
Infant, Small for Gestational Age
Western Australia
Female
Perinatal Death
Gibberd, A.J.
Simpson, J.M.
Jones, J.
Williams, Robyn
Stanley, F.
Eades, Sandra
A large proportion of poor birth outcomes among Aboriginal Western Australians are attributable to smoking, alcohol and substance misuse, and assault
title A large proportion of poor birth outcomes among Aboriginal Western Australians are attributable to smoking, alcohol and substance misuse, and assault
title_full A large proportion of poor birth outcomes among Aboriginal Western Australians are attributable to smoking, alcohol and substance misuse, and assault
title_fullStr A large proportion of poor birth outcomes among Aboriginal Western Australians are attributable to smoking, alcohol and substance misuse, and assault
title_full_unstemmed A large proportion of poor birth outcomes among Aboriginal Western Australians are attributable to smoking, alcohol and substance misuse, and assault
title_short A large proportion of poor birth outcomes among Aboriginal Western Australians are attributable to smoking, alcohol and substance misuse, and assault
title_sort large proportion of poor birth outcomes among aboriginal western australians are attributable to smoking, alcohol and substance misuse, and assault
topic Science & Technology
Life Sciences & Biomedicine
Obstetrics & Gynecology
Birthweight
Preterm birth
Perinatal mortality
Aboriginal and Torres Strait Islander Australians
Indigenous
Linked routinely-collected data
GESTATIONAL-AGE
USE DISORDERS
PREGNANCY
RISK
PREVALENCE
WOMEN
INTERVENTIONS
PREDICTORS
STILLBIRTH
PATTERNS
Aboriginal and Torres Strait Islander Australians
Birthweight
Indigenous
Linked routinely-collected data
Perinatal mortality
Preterm birth
Adult
Domestic Violence
Female
Humans
Infant, Newborn
Infant, Small for Gestational Age
Logistic Models
Perinatal Death
Pregnancy
Pregnancy Complications
Pregnancy Outcome
Premature Birth
Risk Factors
Smoking
Substance-Related Disorders
Western Australia
Humans
Pregnancy Complications
Premature Birth
Substance-Related Disorders
Pregnancy Outcome
Logistic Models
Risk Factors
Smoking
Pregnancy
Domestic Violence
Adult
Infant, Newborn
Infant, Small for Gestational Age
Western Australia
Female
Perinatal Death
url http://hdl.handle.net/20.500.11937/91262