Berman Ye'elah E, Newnham John P, Ward Sarah V, Brown Kiarna, Doherty Dorota A
Division of Obstetrics and Gynaecology, Medical School, The University of Western Australia, Perth, Western Australia, Australia.
Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Aust N Z J Obstet Gynaecol. 2024 Dec;64(6):556-565. doi: 10.1111/ajo.13832. Epub 2024 Jun 4.
Under-identification of Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) people can result in inaccurate estimation of health outcomes. Data linkage has improved identification of Aboriginal people in administrative datasets.
To compare three methods of ascertainment of Aboriginal status using only pregnancy data from the Western Australian Midwives Notification System (MNS), to the linked Indigenous Status Flag (ISF) derived by the Department of Health.
This retrospective population-based cohort study utilised logistic regression to determine which demographic characteristics were associated with under-identification, and the effect of ascertainment method on perinatal adverse outcomes.
All methods identified a core group of 19 017 (83.0%) Aboriginal women and the ISF identified 2298 (10.0%) women who were not identified using any other method. Under-ascertainment was lowest when a woman's Aboriginal status was determined by ever being recorded as Aboriginal in the MNS data, and highest when taken as it had been recorded for the birth in question. Maternal age <20 years, smoking during pregnancy, pre-existing diabetes, a history of singleton preterm birth and being in the lowest 20% of Socio-Economic Indexes for Areas score were all associated with a higher chance of being identified by the methods using only the MNS. These methods were less likely to identify nulliparous women, and those with maternal age ≥35 years. The method of ascertainment of Aboriginality did not make a significant difference to the adjusted predicted marginal probabilities of adverse perinatal outcomes.
Unlinked pregnancy data can be used for epidemiological research in Aboriginal obstetric populations.
对原住民及托雷斯海峡岛民（以下简称原住民）的识别不足可能导致对健康结果的估计不准确。数据链接改善了行政数据集中对原住民的识别。
仅使用西澳大利亚助产士通报系统（MNS）中的妊娠数据，将三种确定原住民身份的方法与卫生部得出的关联原住民身份标志（ISF）进行比较。
这项基于人群的回顾性队列研究利用逻辑回归来确定哪些人口统计学特征与识别不足相关，以及确定方法对围产期不良结局的影响。
所有方法都识别出了19017名（83.0%）原住民女性的核心群体，ISF识别出了2298名（10.0%）未被其他任何方法识别的女性。当根据女性在MNS数据中是否曾被记录为原住民来确定其原住民身份时，识别不足率最低；而根据所涉出生记录来确定时，识别不足率最高。母亲年龄<20岁、孕期吸烟、既往糖尿病史、单胎早产史以及处于地区社会经济指数得分最低的20%，均与仅使用MNS的方法识别出的可能性较高相关。这些方法识别初产妇以及母亲年龄≥35岁的女性的可能性较小。确定原住民身份的方法对围产期不良结局的调整预测边际概率没有显著差异。
未链接的妊娠数据可用于原住民产科人群的流行病学研究。
