Rates of stillbirth by maternal region of birth and gestational age in New South Wales, Australia 2004-2015

doi:10.1111/ajo.13085

. 2020 Jun;60(3):425-432.

doi: 10.1111/ajo.13085. Epub 2019 Nov 5.

Rates of stillbirth by maternal region of birth and gestational age in New South Wales, Australia 2004-2015

Ye'elah Berman^{1

2}, Ibinabo Ibiebele^{1

3}, Jillian A Patterson^{1

3}, Deborah Randall^{1

3}, Jane B Ford^{1

3}, Tanya Nippita^{1

3

4}, Jonathan M Morris^{1

3

4}, Miranda L Davies-Tuck^{5

6}, Siranda Torvaldsen^{1

3

7}

Affiliations

¹ The University of Sydney Northern Clinical School, Women and Babies Research, St Leonards, New South Wales, Australia.
² NSW Biostatistics Training Program, NSW Ministry of Health, Sydney, New South Wales, Australia.
³ Northern Sydney Local Health District, Kolling Institute, New South Wales, Australia.
⁴ Department of Obstetrics and Gynaecology, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia.
⁵ The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.
⁶ Consultative Council on Obstetric and Paediatric Mortality and Morbidity, VIC Department of Health, Melbourne, Victoria, Australia.
⁷ School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia.

PMID: 32049360
DOI: 10.1111/ajo.13085

Rates of stillbirth by maternal region of birth and gestational age in New South Wales, Australia 2004-2015

Ye'elah Berman et al. Aust N Z J Obstet Gynaecol. 2020 Jun.

. 2020 Jun;60(3):425-432.

doi: 10.1111/ajo.13085. Epub 2019 Nov 5.

Authors

Affiliations

¹ The University of Sydney Northern Clinical School, Women and Babies Research, St Leonards, New South Wales, Australia.
² NSW Biostatistics Training Program, NSW Ministry of Health, Sydney, New South Wales, Australia.
³ Northern Sydney Local Health District, Kolling Institute, New South Wales, Australia.
⁴ Department of Obstetrics and Gynaecology, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia.
⁵ The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.
⁶ Consultative Council on Obstetric and Paediatric Mortality and Morbidity, VIC Department of Health, Melbourne, Victoria, Australia.
⁷ School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia.

PMID: 32049360
DOI: 10.1111/ajo.13085

Abstract

Background: Research suggests that in Australia, maternal region of birth is a risk factor for stillbirth.

Aims: We aimed to examine the relationship between stillbirth and maternal region of birth in New South Wales (NSW), Australia from 2004 to 2015.

Methods: Adjusted logistic regression was used to determine odds of stillbirth by maternal region of birth, compared with Australian or New Zealand-born (AUS/NZ-born) women. Intervention rates (induction or pre-labour caesarean) by maternal region of birth, over time, were also examined. Interaction terms were used to assess change in relative odds of stillbirth, over two time periods (2004-2011 and 2012-2015).

Results: There were 944 457 singleton births ≥24 weeks gestation that met the study inclusion criteria and 3221 of these were stillbirths, giving a stillbirth rate of 3.4 per 1000 births. After adjustment for confounders, South Asian (adjusted odds ratio (aOR) 1.42, 95% CI 1.24-1.62), Oceanian (aOR 1.45, 95% CI 1.17-1.80) and African (aOR 1.46, 96% CI 1.19-1.80) born women had significantly higher odds of stillbirth that AUS/NZ-born women. Intervention rates increased from the earlier to the later time period by 13.1% across the study population, but the increase was larger in African and South Asian-born women (18.1% and 19.6% respectively) than AUS/NZ-born women (11.2%). There was a significant interaction between ethnicity and time period for South Asian-born women in the all-births model, with their stillbirth rates becoming closer to AUS/NZ-born women in the later period.

Conclusion: South Asian, African and Oceanian maternal region of birth are independent risk factors for stillbirth in NSW.

Keywords: birth intervention; ethnicity; gestational age; maternal region of birth; stillbirth.

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References

1. Lawn JE, Blencowe H, Waiswa P, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet 2016; 387: 587-603.
1. Australian Institute of Health and Welfare (AIHW). Perinatal deaths in Australia: 2013-2014. Canberra: AIHW, 2018. Cat no. PER 94. Available from URL: https://www.aihw.gov.au/getmedia/78784f2e-2f61-47ea-9908-84b34441ae0a/ai...
1. Flenady V, Wojcieszek AM, Middleton P, et al. Stillbirths: recall to action in high-income countries. Lancet 2016; 387: 691-702.
1. Flenady V, Koopmans L, Middleton P, et al. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet 2011; 377: 1331-40.
1. McCowan LME, Thompson JMD, Cronin RS, et al. Going to sleep in the supine position is a modifiable risk factor for late pregnancy stillbirth; Findings from the New Zealand multicentre stillbirth case-control study. PLoS ONE 2017; 12: e0179396.

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[1] Lawn JE, Blencowe H, Waiswa P, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet 2016; 387: 587-603.

[2] Lawn JE, Blencowe H, Waiswa P, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet 2016; 387: 587-603.

[3] Australian Institute of Health and Welfare (AIHW). Perinatal deaths in Australia: 2013-2014. Canberra: AIHW, 2018. Cat no. PER 94. Available from URL: https://www.aihw.gov.au/getmedia/78784f2e-2f61-47ea-9908-84b34441ae0a/ai...

[4] Australian Institute of Health and Welfare (AIHW). Perinatal deaths in Australia: 2013-2014. Canberra: AIHW, 2018. Cat no. PER 94. Available from URL: https://www.aihw.gov.au/getmedia/78784f2e-2f61-47ea-9908-84b34441ae0a/ai...

[5] Flenady V, Wojcieszek AM, Middleton P, et al. Stillbirths: recall to action in high-income countries. Lancet 2016; 387: 691-702.

[6] Flenady V, Wojcieszek AM, Middleton P, et al. Stillbirths: recall to action in high-income countries. Lancet 2016; 387: 691-702.

[7] Flenady V, Koopmans L, Middleton P, et al. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet 2011; 377: 1331-40.

[8] Flenady V, Koopmans L, Middleton P, et al. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet 2011; 377: 1331-40.

[9] McCowan LME, Thompson JMD, Cronin RS, et al. Going to sleep in the supine position is a modifiable risk factor for late pregnancy stillbirth; Findings from the New Zealand multicentre stillbirth case-control study. PLoS ONE 2017; 12: e0179396.

[10] McCowan LME, Thompson JMD, Cronin RS, et al. Going to sleep in the supine position is a modifiable risk factor for late pregnancy stillbirth; Findings from the New Zealand multicentre stillbirth case-control study. PLoS ONE 2017; 12: e0179396.

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Rates of stillbirth by maternal region of birth and gestational age in New South Wales, Australia 2004-2015

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Rates of stillbirth by maternal region of birth and gestational age in New South Wales, Australia 2004-2015

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