Indigenous birth outcomes at a Victorian urban hospital, a retrospective 5-year cohort study 2010-2014

Abstract

Background: Indigenous people in Australia experience higher rates of preterm birth and low birthweight than their nonindigenous counterparts. There is currently no data on these rates from Victoria, with the data coming from states with higher indigenous proportions.

Materials and methods: Five years (1st January 2010-31st December 2014) of retrospective data from The Northern Hospital's (Melbourne, Victoria) database were analysed. Mothers and babies were split according to self-reported indigenous status: 13800 nonindigenous mothers, 185 indigenous mothers, 301 indigenous babies and 13843 nonindigenous babies. Primary outcomes measured were low birthweight (LBW) and preterm birth.

Results: There was a higher incidence of indigenous babies born preterm (8.8% vs 5.9%, P = 0.034), but the adjusted odds ratios for preterm birth were not significant (indigenous babies OR 1.19, 95% CI: 0.77-1.87, indigenous mothers OR 0.97, CI: 0.52-1.80). There was a similar incidence of LBW among indigenous and nonindigenous babies (6.5% vs 5.4%, P = 0.416). The rate of indigenous women smoking was 29.3% compared to 12.3% of nonindigenous women (P < 0.001), and 40.3% were obese compared to 28.7% (P = 0.001). Indigenous women had lower rates of diabetes (pre-existing or gestational diabetes, 6.1% vs 13.5% P = 0.003).

Conclusion: Heterogeneity of indigenous people and geography means that inferences about indigenous health are difficult to make. It appears that Victorian urban indigenous women have similar rates of preterm birth and LBW to nonindigenous women. While there were pleasing results concerning LBW, antenatal care, diabetes and preterm birth, the rates of smoking and obesity remain a challenge in the indigenous population.

Keywords: health services; indigenous; infant; low birthweight; premature birth; smoking; urban population.