Pervin Sonia, Kearney Lauren, Giudice Sonita, Holzapfel Sherry, Denaro Tara, Dyer Jodi, Cole Phillipa E, Callaway Leonie
Women's and Newborn Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
School of Nursing, Midwifery & Social Work, The University of Queensland, Brisbane, Queensland, Australia.
Aust N Z J Obstet Gynaecol. 2024 Dec;64(6):608-618. doi: 10.1111/ajo.13843. Epub 2024 Jun 7.
To examine low birth weight (LBW) in First Nations babies born in a large metropolitan health service in Queensland, Australia.
A retrospective population-based study using routinely collected data from administrative data sources. All singleton births in metropolitan health services, Queensland, Australia of ≥20 weeks gestation or at least 400 g birthweight and had information on First Nations status and born between 2019 and 2021 were included. The study measured birthweight and birthweight z-score, and also identified the predictors of LBW. Multivariate regression models were adjusted by demographic, socioeconomic and perinatal factors.
First Nations babies had higher rates of LBW (11.4% vs 6.9%, P < 0.001), with higher rates of preterm birth (13.9% vs 8.8%, P < 0.001). In all babies, the most important factors contributing to LBW were: maternal smoking after 20 weeks of gestation; maternal pre-pregnancy underweight (body mass index <18.5 kg/m); nulliparity; socioeconomic disadvantage; geographical remoteness; less frequent antenatal care; history of cannabis use; pre-existing cardiovascular disease; pre-eclampsia; antepartum haemorrhage; and birth outcomes including prematurity and female baby. After adjusting for all contributing factors, no difference in odds of LBW was observed between First Nations and non-First Nation babies.
First Nations status was not an independent factor influencing LBW in this cohort, after adjustment for identifiable factors. The disparity in LBW relates to modifiable risk factors, socioeconomic disadvantage, and prematurity. Upscaling culturally safe maternity care, focusing on modifiable risk factors is required to address LBW in Australian women.
研究澳大利亚昆士兰州一家大型都市医疗服务机构中出生的原住民婴儿的低出生体重（LBW）情况。
一项基于人群的回顾性研究，使用从行政数据源常规收集的数据。纳入了澳大利亚昆士兰州都市医疗服务机构中所有妊娠≥20周或出生体重至少400克、有原住民身份信息且于2019年至2021年期间出生的单胎分娩。该研究测量了出生体重和出生体重Z评分，并确定了低出生体重的预测因素。多变量回归模型根据人口统计学、社会经济和围产期因素进行了调整。
原住民婴儿的低出生体重发生率较高（11.4%对6.9%，P＜0.001），早产率也较高（13.9%对8.8%，P＜0.001）。在所有婴儿中，导致低出生体重的最重要因素包括：妊娠20周后母亲吸烟；母亲孕前体重过轻（体重指数＜18.5kg/m）；初产；社会经济劣势；地理位置偏远；产前检查次数较少；大麻使用史；既往心血管疾病；先兆子痫；产前出血；以及包括早产和女婴在内的出生结局。在对所有影响因素进行调整后，未观察到原住民婴儿和非原住民婴儿在低出生体重几率上的差异。
在对可识别因素进行调整后，原住民身份并非该队列中影响低出生体重的独立因素。低出生体重的差异与可改变的风险因素、社会经济劣势和早产有关。需要加强具有文化安全性的孕产妇护理，关注可改变的风险因素，以解决澳大利亚女性的低出生体重问题。
