Anaemia is a critical public health problem for Aboriginal and Torres Strait Islander pregnant women and children. In pregnancy, anaemia can have adverse outcomes for mother and child including: increased maternal and infant mortality, premature delivery, low birth weight, low infant iron stores, and anaemia. In children, anaemia has immediate and long-term implications affecting health, development, cognition, learning ability and economic productivity. There is little evidence that identifies risk factors for anaemia in Aboriginal children and no studies in this population have determined the contribution of maternal anaemia in pregnancy to the development in childhood anaemia.
A retrospective cohort study was conducted to identify maternal and perinatal risks associated with childhood anaemia in three remote Aboriginal communities in the Katherine East Region, Northern Territory. Informed consent was obtained from mothers who had a child born between 2004-2014 to extract electronic data from the antenatal record pertaining to that child and child's primary health care presentations for the first two years of life. The records were linked providing health care data on the first 1000 days of life (conception to two years of age) for analysis. Univariate logistic regression was performed to determine the effect of perinatal risk factors associated with the development of childhood anaemia.
One hundred and seventy mother/child dads consented to participate. Prevalence of maternal anaemia in pregnancy was higher in the third trimester (62%) compared to the first (46%) and second trimesters (48%) . Nearly half of all children were anaemic, with similar prevalence at six months (47%), 12 months (50%), 18 months (46%) and 24 months (40%) of age. Maternal anaemia in pregnancy (OR 4.42 95% CI, 2.08 - 9.36) and low birth weight (OR 2.62, 95% CI 1.2 - 5.70), but not prematurity (OR 1.87,95% C1 0.84 - 4.15) were associated with an increased risk of childhood anaemia at six months of age.
This is the first study to identify the association of maternal anaemia with childhood anaemia in the Australian Aboriginal population. If this finding is generalisable across the Norther Territory, it will impact public health policy and practice with a renewed focus on improving screening and treatment rates of maternal anaemia in pregnancy. The current practice of administering prophylactic icon supplementation only to children who are born low birth weight or premature would be of greater benefit if expanded to include children born to anaemic mothers.
|Date of Award||18 Apr 2018|
|Sponsors||The Lowitja Institute (CRC for Aboriginal Health)|
|Supervisor||Therese Kearns (Supervisor) & Federica Barzi (Supervisor)|