Division of Maternity Services, The Royal Women's Hospital, 20 Flemington Rd, Parkville, VIC, 3052, Australia.
Department of Obstetrics and Gynaecology, University of Melbourne, The Royal Women's Hospital, Parkville, VIC, 3052, Australia.
BMC Pregnancy Childbirth. 2018 Sep 24;18(1):382. doi: 10.1186/s12884-018-1946-3.
A key focus of the Closing the Gap campaign is to reduce low birthweight in Aboriginal babies. Limited research exists on factors affecting Aboriginal birthweight in urban areas.
Retrospective cohort analysis of 38,382 births (38,167 non-Aboriginal, 215 Aboriginal) at the Royal Women's Hospital in Melbourne from January 2010 to December 2015. Aboriginal status was defined by mothers who identified themselves and their baby as Aboriginal or Torres Strait Islander. The aim was to examine the association of maternal health risk behaviours and obstetric complications with birthweight of infants born to Australian Aboriginal women birthing in an urban setting.
Aboriginal babies had a lower mean birthweight than non-Aboriginal babies (mean difference -290 g; 95% confidence interval [CI] -413, - 166 g), but when accounting for gestational age and sex there was little difference (mean difference 5 g; 95% CI -53, 6 g). Aboriginal babies were significantly more likely to be delivered preterm < 37 weeks (23.3% vs 7.9%, odds ratio [OR] 3.58; 95% CI 2.58, 4.95) and be of low birthweight < 2500 g (22.3% vs 6.7%, OR 4.03; 95% CI 2.90, 5.60) or very low birthweight < 1500 g (9.8% vs 1.8%, OR 5.81; 95% CI 3.67, 9.16). Aboriginal mothers were significantly more likely to be teenage mothers (9.8% vs 1.6%, OR 5.72; 95% CI 3.54, 9.24), smoke cigarettes throughout the pregnancy (53.8% vs 5.6%, OR 17.2; 95% CI 12.8, 23.0), and use drugs (26.5% vs 2.4%, OR 14.3; 95% CI 10.4, 19.6) during pregnancy, all of which were associated with lower birthweight. Aboriginal mothers were also more likely to have a mental health diagnosis (49.5% vs 18.8%, OR 3.77; 95% CI 2.86, 4.97), be overweight (59.9% vs 42.6%, OR 1.88; 95% CI 1.39, 2.56) and have diabetes (15.3% vs 7.3%, OR 2.31; 95% CI 1.59, 3.35) which were all associated with higher birthweight.
Aboriginal babies born in metropolitan Melbourne are more likely to be of low birthweight compared with non-Aboriginal babies, which in turn was related to higher rates of prematurity and not to being small for gestational age.
缩小差距运动的一个重点是降低原住民婴儿的低出生体重。关于城市地区影响原住民出生体重的因素的研究有限。
对 2010 年 1 月至 2015 年 12 月在墨尔本皇家妇女医院分娩的 38382 名（非原住民 38167 名，原住民 215 名）婴儿进行回顾性队列分析。原住民身份由自我认同为原住民或托雷斯海峡岛民的母亲及其婴儿确定。目的是研究母亲健康风险行为和产科并发症与在城市环境中分娩的澳大利亚原住民妇女所生婴儿的出生体重之间的关联。
原住民婴儿的平均出生体重低于非原住民婴儿（平均差异 -290 克；95%置信区间 [CI] -413，-166 克），但考虑到胎龄和性别，差异很小（平均差异 5 克；95% CI -53，6 克）。原住民婴儿早产（<37 周）的比例明显更高（23.3%比 7.9%，比值比 [OR] 3.58；95% CI 2.58，4.95），低出生体重（<2500 克）的比例明显更高（22.3%比 6.7%，OR 4.03；95% CI 2.90，5.60）或极低出生体重（<1500 克）的比例明显更高（9.8%比 1.8%，OR 5.81；95% CI 3.67，9.16）。原住民母亲明显更有可能是青少年母亲（9.8%比 1.6%，OR 5.72；95% CI 3.54，9.24），在整个怀孕期间吸烟（53.8%比 5.6%，OR 17.2；95% CI 12.8，23.0），并在怀孕期间使用毒品（26.5%比 2.4%，OR 14.3；95% CI 10.4，19.6），所有这些都与较低的出生体重有关。原住民母亲也更有可能被诊断出患有精神疾病（49.5%比 18.8%，OR 3.77；95% CI 2.86，4.97）、超重（59.9%比 42.6%，OR 1.88；95% CI 1.39，2.56）和患有糖尿病（15.3%比 7.3%，OR 2.31；95% CI 1.59，3.35），所有这些都与较高的出生体重有关。
与非原住民婴儿相比，在墨尔本大都市出生的原住民婴儿更有可能体重较低，而这反过来又与较高的早产率有关，而不是与胎龄小有关。
