Risk factors for preterm, low birthweight and small for gestational age births among Aboriginal women from remote communities in Northern Australia
Risk factors for preterm, low birthweight and small for gestational age births among Aboriginal women from remote communities in Northern Australia
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DOI：
10.1016/j.wombi.2017.03.003
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发表时间：
2017-10-01
期刊：
影响因子：
3.8
通讯作者：
Barclay, Lesley M.
中科院分区：
文献类型：
--
作者：
Kildea, Sue V.;Gao, Yu;Barclay, Lesley M.
目的：探讨边远地区土著妇女早产、低出生体重和小胎龄儿的危险因素。方法：研究包括2004-2006年（回顾性队列）和2009-2011年（前瞻性队列）来自澳大利亚北领地两个大型偏远原住民社区的713例单胎新生儿。描述了人口统计学、妊娠特征、劳动和出生结果。进行多因素logistic回归分析，并报告校正优势比。结果：早产率为19.4%，低出生体重率为17.4%，小于胎龄率为16.3%。早产的危险因素有：未成年母亲、以前的早产、没有吸烟记录、产前检查不充分、有妊娠性高血压、产前出血或胎盘并发症。在调整性别和出生妊娠后，低出生体重的唯一显著风险因素是首次母亲。对小胎龄婴儿来说，唯一重要的风险因素是女性生第一个孩子。结论：这些事件的发生率很高，且随时间变化不大。一些风险因素是可以改变和治疗的，但需要在偏远社区本身提供早期、高质量、以妇女为中心的文化响应性护理。建议采用另一种方法。(C) 2017澳大利亚助产士学院。Elsevier Ltd.出版。版权所有。
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. (C) 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.