Perinatal risk factors associated with skin infection hospitalisation in Western Australian Aboriginal and Non-Aboriginal children

Rosanne Barnes, Asha C. Bowen, Roz Walker, Steven Y.C. Tong, Jodie McVernon, Patricia T. Campbell, Parveen Fathima, Nicholas H. de Klerk, Yue Wu, Christopher C. Blyth, Jonathan R. Carapetis, Hannah C. Moore

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    Abstract

    Background: Hospitalisation with skin infection in Western Australian (WA) Aboriginal children is common, with the highest rates in infants and children from remote WA. 

    Objective: We aimed to quantify infant, maternal, and sociodemographic risk factors for skin infection hospitalisation in WA children, focussing on Aboriginal children aged <17 years. 

    Methods: We conducted a retrospective population-based cohort study with linked perinatal and hospitalisation data on WA-born children (1996-2012), of whom 31 348 (6.7%) were Aboriginal. We used Cox regression to calculate adjusted hazard ratios and associated population attributable fractions (PAFs) for perinatal factors attributed to first hospitalisation with skin infection. To identify specific risk factors for early-onset infection, we further restricted the cohort to infants aged <1 year. 

    Results: Overall, 5439 (17.4%) Aboriginal and 6750 (1.5%) non-Aboriginal children were hospitalised at least once with a skin infection. Aboriginal infants aged <1 year had the highest skin infection hospitalisation rate (63.2 per 1000 child-years). The strongest risk factors in Aboriginal children aged <17 years were socio-economic disadvantage, very remote location at birth, and multi-parity (≥3 previous pregnancies) accounting for 24%, 23%, and 15% of skin infection hospitalisations, respectively. Other risk factors included maternal age <20 years, maternal smoking during pregnancy, and low birthweight. 

    Conclusions: We have quantified the relative influence of perinatal risk factors associated with skin infection hospitalisations in WA children, providing measures indicating which factors have the potential to reduce the most hospitalisations. Our evidence not only supports existing calls for substantial government investment in addressing underlying social and environmental barriers to healthy skin in WA Aboriginal children but also identifies potential areas to target health promotion messaging at individuals/families on maternal smoking during pregnancy and skin hygiene for families.

    Original languageEnglish
    Pages (from-to)374-383
    Number of pages10
    JournalPaediatric and Perinatal Epidemiology
    Volume33
    Issue number5
    DOIs
    Publication statusPublished - Sep 2019

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    Hospitalization
    Skin
    Infection
    Mothers
    Pregnancy
    Smoking
    Hospitalized Child
    Maternal Age
    Parity
    Health Promotion
    Hygiene
    Population
    Cohort Studies
    Economics
    Parturition

    Cite this

    Barnes, Rosanne ; Bowen, Asha C. ; Walker, Roz ; Tong, Steven Y.C. ; McVernon, Jodie ; Campbell, Patricia T. ; Fathima, Parveen ; de Klerk, Nicholas H. ; Wu, Yue ; Blyth, Christopher C. ; Carapetis, Jonathan R. ; Moore, Hannah C. / Perinatal risk factors associated with skin infection hospitalisation in Western Australian Aboriginal and Non-Aboriginal children. In: Paediatric and Perinatal Epidemiology. 2019 ; Vol. 33, No. 5. pp. 374-383.
    @article{c9c8cbefe7fa439badb278157f2f1bdb,
    title = "Perinatal risk factors associated with skin infection hospitalisation in Western Australian Aboriginal and Non-Aboriginal children",
    abstract = "Background: Hospitalisation with skin infection in Western Australian (WA) Aboriginal children is common, with the highest rates in infants and children from remote WA. Objective: We aimed to quantify infant, maternal, and sociodemographic risk factors for skin infection hospitalisation in WA children, focussing on Aboriginal children aged <17 years. Methods: We conducted a retrospective population-based cohort study with linked perinatal and hospitalisation data on WA-born children (1996-2012), of whom 31 348 (6.7{\%}) were Aboriginal. We used Cox regression to calculate adjusted hazard ratios and associated population attributable fractions (PAFs) for perinatal factors attributed to first hospitalisation with skin infection. To identify specific risk factors for early-onset infection, we further restricted the cohort to infants aged <1 year. Results: Overall, 5439 (17.4{\%}) Aboriginal and 6750 (1.5{\%}) non-Aboriginal children were hospitalised at least once with a skin infection. Aboriginal infants aged <1 year had the highest skin infection hospitalisation rate (63.2 per 1000 child-years). The strongest risk factors in Aboriginal children aged <17 years were socio-economic disadvantage, very remote location at birth, and multi-parity (≥3 previous pregnancies) accounting for 24{\%}, 23{\%}, and 15{\%} of skin infection hospitalisations, respectively. Other risk factors included maternal age <20 years, maternal smoking during pregnancy, and low birthweight. Conclusions: We have quantified the relative influence of perinatal risk factors associated with skin infection hospitalisations in WA children, providing measures indicating which factors have the potential to reduce the most hospitalisations. Our evidence not only supports existing calls for substantial government investment in addressing underlying social and environmental barriers to healthy skin in WA Aboriginal children but also identifies potential areas to target health promotion messaging at individuals/families on maternal smoking during pregnancy and skin hygiene for families.",
    keywords = "children, hospitalisations, record linkage, skin infection",
    author = "Rosanne Barnes and Bowen, {Asha C.} and Roz Walker and Tong, {Steven Y.C.} and Jodie McVernon and Campbell, {Patricia T.} and Parveen Fathima and {de Klerk}, {Nicholas H.} and Yue Wu and Blyth, {Christopher C.} and Carapetis, {Jonathan R.} and Moore, {Hannah C.}",
    year = "2019",
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    doi = "10.1111/ppe.12573",
    language = "English",
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    Barnes, R, Bowen, AC, Walker, R, Tong, SYC, McVernon, J, Campbell, PT, Fathima, P, de Klerk, NH, Wu, Y, Blyth, CC, Carapetis, JR & Moore, HC 2019, 'Perinatal risk factors associated with skin infection hospitalisation in Western Australian Aboriginal and Non-Aboriginal children', Paediatric and Perinatal Epidemiology, vol. 33, no. 5, pp. 374-383. https://doi.org/10.1111/ppe.12573

    Perinatal risk factors associated with skin infection hospitalisation in Western Australian Aboriginal and Non-Aboriginal children. / Barnes, Rosanne; Bowen, Asha C.; Walker, Roz; Tong, Steven Y.C.; McVernon, Jodie; Campbell, Patricia T.; Fathima, Parveen; de Klerk, Nicholas H.; Wu, Yue; Blyth, Christopher C.; Carapetis, Jonathan R.; Moore, Hannah C.

    In: Paediatric and Perinatal Epidemiology, Vol. 33, No. 5, 09.2019, p. 374-383.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Perinatal risk factors associated with skin infection hospitalisation in Western Australian Aboriginal and Non-Aboriginal children

    AU - Barnes, Rosanne

    AU - Bowen, Asha C.

    AU - Walker, Roz

    AU - Tong, Steven Y.C.

    AU - McVernon, Jodie

    AU - Campbell, Patricia T.

    AU - Fathima, Parveen

    AU - de Klerk, Nicholas H.

    AU - Wu, Yue

    AU - Blyth, Christopher C.

    AU - Carapetis, Jonathan R.

    AU - Moore, Hannah C.

    PY - 2019/9

    Y1 - 2019/9

    N2 - Background: Hospitalisation with skin infection in Western Australian (WA) Aboriginal children is common, with the highest rates in infants and children from remote WA. Objective: We aimed to quantify infant, maternal, and sociodemographic risk factors for skin infection hospitalisation in WA children, focussing on Aboriginal children aged <17 years. Methods: We conducted a retrospective population-based cohort study with linked perinatal and hospitalisation data on WA-born children (1996-2012), of whom 31 348 (6.7%) were Aboriginal. We used Cox regression to calculate adjusted hazard ratios and associated population attributable fractions (PAFs) for perinatal factors attributed to first hospitalisation with skin infection. To identify specific risk factors for early-onset infection, we further restricted the cohort to infants aged <1 year. Results: Overall, 5439 (17.4%) Aboriginal and 6750 (1.5%) non-Aboriginal children were hospitalised at least once with a skin infection. Aboriginal infants aged <1 year had the highest skin infection hospitalisation rate (63.2 per 1000 child-years). The strongest risk factors in Aboriginal children aged <17 years were socio-economic disadvantage, very remote location at birth, and multi-parity (≥3 previous pregnancies) accounting for 24%, 23%, and 15% of skin infection hospitalisations, respectively. Other risk factors included maternal age <20 years, maternal smoking during pregnancy, and low birthweight. Conclusions: We have quantified the relative influence of perinatal risk factors associated with skin infection hospitalisations in WA children, providing measures indicating which factors have the potential to reduce the most hospitalisations. Our evidence not only supports existing calls for substantial government investment in addressing underlying social and environmental barriers to healthy skin in WA Aboriginal children but also identifies potential areas to target health promotion messaging at individuals/families on maternal smoking during pregnancy and skin hygiene for families.

    AB - Background: Hospitalisation with skin infection in Western Australian (WA) Aboriginal children is common, with the highest rates in infants and children from remote WA. Objective: We aimed to quantify infant, maternal, and sociodemographic risk factors for skin infection hospitalisation in WA children, focussing on Aboriginal children aged <17 years. Methods: We conducted a retrospective population-based cohort study with linked perinatal and hospitalisation data on WA-born children (1996-2012), of whom 31 348 (6.7%) were Aboriginal. We used Cox regression to calculate adjusted hazard ratios and associated population attributable fractions (PAFs) for perinatal factors attributed to first hospitalisation with skin infection. To identify specific risk factors for early-onset infection, we further restricted the cohort to infants aged <1 year. Results: Overall, 5439 (17.4%) Aboriginal and 6750 (1.5%) non-Aboriginal children were hospitalised at least once with a skin infection. Aboriginal infants aged <1 year had the highest skin infection hospitalisation rate (63.2 per 1000 child-years). The strongest risk factors in Aboriginal children aged <17 years were socio-economic disadvantage, very remote location at birth, and multi-parity (≥3 previous pregnancies) accounting for 24%, 23%, and 15% of skin infection hospitalisations, respectively. Other risk factors included maternal age <20 years, maternal smoking during pregnancy, and low birthweight. Conclusions: We have quantified the relative influence of perinatal risk factors associated with skin infection hospitalisations in WA children, providing measures indicating which factors have the potential to reduce the most hospitalisations. Our evidence not only supports existing calls for substantial government investment in addressing underlying social and environmental barriers to healthy skin in WA Aboriginal children but also identifies potential areas to target health promotion messaging at individuals/families on maternal smoking during pregnancy and skin hygiene for families.

    KW - children

    KW - hospitalisations

    KW - record linkage

    KW - skin infection

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    U2 - 10.1111/ppe.12573

    DO - 10.1111/ppe.12573

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    JO - Paediatric and Perinatal Epidemiology

    JF - Paediatric and Perinatal Epidemiology

    SN - 0269-5022

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    ER -