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The urban–remote divide for Indigenous perinatal outcomes
Author(s) -
Graham Simon,
Jackson Pulver Lisa R,
Wang Yueping Alex,
Kelly Paul M,
Laws Paula J,
Grayson Narelle,
Sullivan Elizabeth A
Publication year - 2007
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2007.tb01024.x
Subject(s) - medicine , apgar score , residence , odds ratio , population , demography , indigenous , odds , small for gestational age , gestational age , birth weight , pregnancy , pediatrics , logistic regression , environmental health , ecology , genetics , pathology , sociology , biology
Objective: To determine whether remoteness category of residence of Indigenous women affects the perinatal outcomes of their newborn infants. Design and participants: A population‐based study of 35 240 mothers identified as Indigenous and their 35 658 babies included in the National Perinatal Data Collection in 2001–2004. Main outcome measures: Australian Standard Geographical Classification remoteness category, birthweight, Apgar score at 5 minutes, stillbirth, gestational age and a constructed measure of perinatal outcomes of babies called “healthy baby” (live birth, singleton, 37–41 completed weeks’ gestation, 2500–4499 g birthweight, and an Apgar score at 5 minutes ≥ 7). Results: The proportion of healthy babies in remote, regional and city areas was 74.9%, 77.7% and 77.6%, respectively. After adjusting for age, parity, smoking and diabetes or hypertension, babies born to mothers in remote areas were less likely to satisfy the study criteria of being a healthy baby (adjusted odds ratio [AOR], 0.87; 95% CI, 0.81–0.93) compared with those born in cities. Babies born to mothers living in remote areas had higher odds of being of low birthweight (AOR, 1.09; 95% CI, 1.01–1.19) and being born with an Apgar score < 7 at 5 minutes (AOR, 1.63; 95% CI, 1.39–1.92). Conclusions: Only three in four babies born to Indigenous mothers fell into the “healthy baby” category, and those born in more remote areas were particularly disadvantaged. These findings demonstrate the continuing need for urgent and concerted action to address the persistent perinatal inequity in the Indigenous population.