Open AccessRates of neonatal morbidity by maternal region of birth and gestational age in New South Wales, Australia 2003‐2016
Author(s) -
Berman Ye’elah,
Ibiebele Ibinabo,
Randall Deborah,
Torvaldsen Siranda,
Nippita Tanya A.,
Bowen Jennifer,
Baldwin Heather J.,
Todd Stephanie M.,
Morris Jonathan M.,
Ford Jane B.,
Patterson Jillian A.
Publication year - 2021
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.14012
Subject(s) - medicine , gestational age , gestation , obstetrics , relative risk , poisson regression , cohort study , pediatrics , small for gestational age , retrospective cohort study , live birth , confidence interval , pregnancy , population , surgery , genetics , environmental health , biology
Research suggests that neonatal morbidity differs by maternal region of birth at different gestational ages. This study aimed to determine the overall and gestation‐specific risk of neonatal morbidity by maternal region of birth, after adjustment for maternal, infant and birth characteristics, for women giving birth in New South Wales, Australia, from 2003 to 2016. Material and methods The study utilized a retrospective cohort study design using linked births, hospital and deaths data. Modified Poisson regression was used to determine risk with 95% confidence intervals (95% CI) of neonatal morbidity by maternal region of birth, overall and at each gestational age, compared with Australian or New Zealand‐born women giving birth at 39 weeks. Results There were 1 074 930 live singleton births ≥32 weeks’ gestation that met the study inclusion criteria, and 44 394 of these were classified as morbid, giving a neonatal morbidity rate of 4.13 per 100 live births. The gestational age‐specific neonatal morbidity rate declined from 32 weeks’ gestation, reaching a minimum at 39 weeks in all maternal regions of birth. The unadjusted neonatal morbidity rate was highest in South Asian‐born women at most gestations. Adjusted rates of neonatal morbidity between 32 and 44 weeks were significantly lower for babies born to East (adjusted relative risk [aRR] 0.65, 95% CI 0.62‐0.68), South‐east (aRR 0.76, 95% CI 0.73‐0.79) and West Asian‐born (aRR 0.93, 95% CI 0.88‐0.98) mothers, and higher for babies of Oceanian‐born (aRR 1.11, 95% CI 1.04‐1.18) mothers, compared with Australian or New Zealand‐born mothers. Babies of African, Oceanian, South Asian and West Asian‐born women had a lower adjusted risk of neonatal morbidity than Australian or New Zealand‐born women until 37 or 38 weeks’ gestation, and thereafter an equal or higher risk in the term and post‐term periods. Conclusions Maternal region of birth is an independent risk factor for neonatal morbidity in New South Wales.