Mothers and Babies Research Centre, John Hunter Hospital, New Lambton Heights, Newcastle, NSW, Australia; Hunter Medical Research Institute, John Hunter Hospital, New Lambton Heights, Newcastle, NSW, Australia; School of Medicine and Public Health, University of Newcastle, NSW, Australia.
Mothers and Babies Research Centre, John Hunter Hospital, New Lambton Heights, Newcastle, NSW, Australia; School of Medicine and Public Health, University of Newcastle, NSW, Australia.
Am J Obstet Gynecol. 2019 Mar;220(3):277.e1-277.e10. doi: 10.1016/j.ajog.2018.10.094. Epub 2018 Nov 4.
Low birthweight is more common in infants of indigenous (Aboriginal and/or Torres Strait Islander) than of White Australian mothers. Controversy exists on whether fetal growth is normally different in different populations.
We sought to determine the relationships of birthweight, birthweight percentiles, and smoking with perinatal outcomes in indigenous vs nonindigenous infants to determine whether the White infant growth charts could be applied to indigenous infants.
Data were analyzed for indigenous status, maternal age and smoking, and perinatal outcomes in 45,754 singleton liveborn infants of at least 20 weeks gestation or 400 g birthweight delivered in New South Wales, Australia, between June 2010 and July 2015.
Indigenous infants (n=6372; 14%) had a mean birthweight 67 g lower than nonindigenous infants (P<.0001; with adjustment for infant sex and maternal body mass index). Indigenous mean birthweight percentile was 4.2 units lower (P<.0001). Adjustment for maternal age, smoking, body mass index, and infant sex reduced the difference in birthweight/percentiles to nonsignificance (12 g; P=.07).
Disparities exist between indigenous and non-indigenous Australian infants for birthweight, birthweight percentile, and adverse outcome rates. Adjustment for smoking and maternal age removed any significant difference in birthweights and birthweight percentiles for indigenous infants. Our data indicate that birthweight percentiles should not be adjusted for indigenous ethnicity because this normalizes disadvantage; because White and indigenous Australians have diverged for approximately 50,000 years, it is likely that the same conclusions apply to other ethnic groups. The disparities in birthweight percentiles that are associated with smoking will likely perpetuate indigenous disadvantage into the future because low birthweight is linked to the development of chronic noncommunicable disease and poorer educational attainment; similar problems may affect other indigenous populations.
与白种澳大利亚母亲的婴儿相比，土著（原住民和/或托雷斯海峡岛民）婴儿的低出生体重更为常见。对于不同人群的胎儿生长是否正常存在争议。
我们旨在确定出生体重、出生体重百分位数和吸烟与围产期结局在土著与非土著婴儿中的关系，以确定是否可以将白人婴儿生长图表应用于土著婴儿。
对 2010 年 6 月至 2015 年 7 月期间在澳大利亚新南威尔士州至少 20 周妊娠或 400 克出生体重的 45754 名单胎活产婴儿的土著身份、母亲年龄和吸烟情况以及围产期结局进行了数据分析。
土著婴儿（n=6372；14%）的平均出生体重比非土著婴儿低 67 克（P<.0001；调整婴儿性别和母亲体重指数后）。土著婴儿的平均出生体重百分位数低 4.2 个单位（P<.0001）。调整母亲年龄、吸烟、体重指数和婴儿性别后，出生体重/百分位数的差异不再具有统计学意义（12 克；P=.07）。
土著和非土著澳大利亚婴儿的出生体重、出生体重百分位数和不良结局发生率存在差异。调整吸烟和母亲年龄后，土著婴儿的出生体重和出生体重百分位数不再存在显著差异。我们的数据表明，不应该根据土著民族调整出生体重百分位数，因为这会使劣势正常化；由于白人和土著澳大利亚人已经分离了大约 5 万年，因此其他族群也可能适用相同的结论。与吸烟相关的出生体重百分位数差异可能会使土著劣势持续存在到未来，因为低出生体重与慢性非传染性疾病和较差的教育程度有关；类似的问题可能会影响其他土著人群。
