澳大利亚两个州的原住民双胞胎的妊娠和分娩特征：一项数据关联研究。

Pregnancy and birth characteristics of Aboriginal twins in two Australian states: a data linkage study.

机构信息

Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia.

School of Population Health, The University of New South Wales, Sydney, Australia.

出版信息

BMC Pregnancy Childbirth. 2021 Jun 28;21(1):448. doi: 10.1186/s12884-021-03945-9.

DOI:10.1186/s12884-021-03945-9

PMID:34182932

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8240393/

Abstract

INTRODUCTION

Perinatal outcomes for singleton pregnancies are poorer, on average, for Aboriginal people than non-Aboriginal people, but little is known about Aboriginal multifetal pregnancies. Yet multifetal pregnancies and births are often more complicated and have poorer outcomes than singleton pregnancies. We describe the pregnancies, births and perinatal outcomes for Aboriginal twins born in Western Australia (WA) and New South Wales (NSW) with comparisons to Aboriginal singletons in both states and to non-Aboriginal births in NSW.

MATERIALS AND METHODS

Whole-population birth records and birth and death registrations were linked for all births during 2000-2013 (WA) and 2002-2008 (NSW). Hospital records and the WA Register of Developmental Anomalies - Cerebral Palsy were linked for all WA births and hospital records for a subset of NSW births. Descriptive statistics are reported for maternal and child demographics, maternal health, pregnancy complications, births and perinatal outcomes.

RESULTS

Thirty-four thousand one hundred twenty-seven WA Aboriginal, 32,352 NSW Aboriginal and 601,233 NSW non-Aboriginal births were included. Pregnancy complications were more common among mothers of Aboriginal twins than Aboriginal singletons (e.g. 17% of mothers of WA twins had hypertension/pre-eclampsia/eclampsia vs 8% of mothers of singletons) but similar to mothers of NSW non-Aboriginal twins. Most Aboriginal twins were born in a principal referral, women's or large public hospital. The hospitals were often far from the mother's home (e.g. 31% of mothers of WA Aboriginal twins gave birth at hospitals located more than 3 h by road from their home). Outcomes were worse for Aboriginal liveborn twins than Aboriginal singletons and non-Aboriginal twins (e.g. 58% of NSW Aboriginal twins were preterm compared to 9% of Aboriginal singletons and 49% non-Aboriginal twins).

CONCLUSIONS

Mothers of Aboriginal twins faced significant challenges during the pregnancy, birth and the postnatal period in hospital and, in addition to accessible specialist medical care, these mothers may need extra practical and psychosocial support throughout their journey.

摘要

简介

单胎妊娠的围产期结局在原住民中平均比非原住民差，但对于原住民多胎妊娠知之甚少。然而，多胎妊娠和分娩通常比单胎妊娠更复杂，结局更差。我们描述了西澳大利亚州（WA）和新南威尔士州（NSW）的原住民双胞胎的妊娠、分娩和围产期结局，并与这两个州的原住民单胎妊娠和新南威尔士州的非原住民分娩进行了比较。

材料和方法

对 2000-2013 年（WA）和 2002-2008 年（NSW）期间的所有出生进行了全人群出生记录和出生及死亡登记的链接。对所有 WA 出生进行了医院记录和 WA 发育异常登记册-脑瘫的链接，对 NSW 出生的一部分进行了医院记录的链接。报告了母亲和儿童人口统计学、母亲健康、妊娠并发症、分娩和围产期结局的描述性统计数据。

结果

纳入了 34127 名 WA 原住民、32352 名 NSW 原住民和 601233 名 NSW 非原住民的分娩。与原住民单胎妊娠的母亲相比，原住民双胞胎妊娠的母亲更常见妊娠并发症（例如，WA 双胞胎母亲中 17%患有高血压/子痫前期/子痫，而单胎母亲中为 8%），但与 NSW 非原住民双胞胎母亲相似。大多数原住民双胞胎在主要转诊、妇女或大型公立医院分娩。这些医院通常离母亲的家很远（例如，WA 原住民双胞胎母亲中有 31%在离家 3 小时以上的医院分娩）。与原住民活产双胞胎相比，原住民活产双胞胎的结局较差，非原住民双胞胎的结局也较差（例如，新南威尔士州 58%的原住民双胞胎早产，而原住民单胎的比例为 9%，非原住民双胞胎的比例为 49%）。