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Success in Closing the Gap: favourable neonatal outcomes in a metropolitan Aboriginal Maternity Group Practice Program
Author(s) -
Bertilone Christina,
McEvoy Suzanne
Publication year - 2015
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/mja14.01754
Subject(s) - closing (real estate) , metropolitan area , clinical practice , medicine , demography , family medicine , nursing , political science , sociology , pathology , law
Objectives: To report differences in neonatal health outcomes for a community‐based antenatal program, the Aboriginal Maternity Group Practice Program (AMGPP; the intervention group), compared with two matched control groups eligible for standard antenatal care. Design: Non‐randomised intervention study using data from the Western Australian Midwives Notification System. Regression models were used to report adjusted odds ratios (aORs) for defined neonatal health outcomes. Setting: The AMGPP employed Aboriginal grandmothers, Aboriginal Health Officers, and midwives working in partnership with existing antenatal services to provide care for pregnant Aboriginal women residing in south metropolitan Perth. Participants: 343 women (with 350 pregnancies) who participated in the AMGPP and gave birth between 1 July 2011 and 31 December 2012; historical and contemporary control groups of pregnant Aboriginal women (each including 350 pregnancies), frequency matched for maternal age and gravidity. Main outcome measures: Preterm births, birthweight, neonatal resuscitation, neonatal hospital length of stay longer than 5 days. Results: Babies born to AMGPP participants were significantly less likely to be born preterm (AMGPP, 9.1% v historical controls, 15.9% [aOR, 0.56; 95% CI, 0.35–0.92]; v contemporary controls, 15.3% [aOR, 0.75; 95% CI, 0.58–0.95]); to require resuscitation at birth (AMGPP, 17.8% v historical controls, 24.4% [aOR, 0.68; 95% CI, 0.47–0.98]; v contemporary controls, 31.2% [aOR, 0.71; 95% CI, 0.60–0.85]), or to have a hospital length of stay of more than 5 days (AMGPP, 4.0% v historical controls, 11.3% [aOR, 0.34; 95% CI, 0.18–0.64]; v contemporary controls, 11.6% [aOR, 0.56; 95% CI, 0.41–0.77]). Conclusion: Participation in the AMGPP in south metropolitan Perth was associated with significantly improved neonatal health outcomes.