Abstract
Background: Preterm birth (PTB) is the single most important cause of perinatal mortality and morbidity in high income countries. In Australia, 8.6% of babies are born preterm but substantial variability exists between States and Territories. Previous reports suggest PTB rates are highest in the Northern Territory (NT), but comprehensive analysis of trends and risk factors are lacking in this region. The objective of this study was to characterise temporal trends in PTB among First Nations and non-First Nations mothers in the Top End of the NT over a 10-year period and to identify perinatal factors associated with the risk of PTB.
Methods: This was a retrospective population-based cohort study of all births in the Top End of the NT over the 10-year period from January 1st, 2008, to December 31st, 2017. We described maternal characteristics, obstetric complications, birth characteristics and annual trends in PTB. The association between the characteristics and the risk of PTB was determined using univariate and multivariate generalised linear models producing crude risk ratios (cRR) and adjusted risk ratios (aRR). Data were analysed overall, in First Nations and non-First Nations women.
Results: During the decade ending in 2017, annual rates of PTB in the Top End of the NT remained consistently close to 10% of all live births. However, First Nations women experienced more than twice the risk of PTB (16%) compared to other women (7%). Leading risk factors for PTB among First Nations women as compared to other women included premature rupture of membranes (RR 12.33; 95% CI 11.78, 12.90), multiple pregnancy (RR 7.24; 95% CI 6.68, 7.83), antepartum haemorrhage (RR 4.36; 95% CI 3.93, 4.84) and pre-existing diabetes (RR 4.18; 95% CI 3.67, 4.76).
Conclusions: First Nations women experience some of the highest PTB rates globally. Addressing specific pregnancy complications provides avenues for intervention, but the story is complex and deeper exploration is warranted. A holistic approach that also acknowledges the influence of socio-demographic influences, such as remote dwelling and disadvantage on disease burden, will be required to improve perinatal outcomes.
| Original language | English |
|---|---|
| Article number | 33 |
| Pages (from-to) | 1-10 |
| Number of pages | 10 |
| Journal | BMC Pregnancy and Childbirth |
| Volume | 24 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Dec 2024 |
Bibliographical note
Funding Information:The authors wish to thank the Child and Youth Development Research Partnership Steering Committee and the Northern Territory Government for access to the repository containing the NT perinatal data set.
Funding Information:
This study has not received any financial support. The Child and Youth Development Research Partnership data repository is supported by a grant from the NT Government. The funders of the repository had no role in the study design, data preparation, analysis, decision to publish or preparation of the manuscript.
Funding Information:
The project was approved by the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research (HREC 2019-3551 and HREC 2018-3261). It was supported by the Menzies School of Health Child Health Division First Nations Reference Group and the First Nations Advisory Group for the Child and Youth Development Research Partnership. Informed consent for all participants was waived by the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research. All research methods were performed in accordance with the Declaration of Helsinki.
Publisher Copyright:
© 2023, Crown.
