a population-based investigation into inequalities amongst indigenous mothers and newborns by place of residence in the northern territory, australia以人群为基础的调查不平等在土著居住地母亲和新生儿的北部地区,澳大利亚.pdfVIP

Steenkamp et al. BMC Pregnancy and Childbirth 2012, 12:44 /1471-2393/12/44 RESEARCH ARTICLE Open Access A population-based investigation into inequalities amongst Indigenous mothers and newborns by place of residence in the Northern territory, Australia 1* 2 1 3 Malinda Steenkamp , Alice Rumbold , Lesley Barclay and Sue Kildea Abstract Background: Comparisons of birth outcomes between Australian Indigenous and non-Indigenous populations show marked inequalities. These comparisons obscure Indigenous disparities. There is much variation in terms of culture, language, residence, and access to services amongst Australian Indigenous peoples. We examined outcomes by region and remoteness for Indigenous subgroups and explored data for communities to inform health service delivery and interventions. Methods: Our population-based study examined maternal and neonatal outcomes for 7,560 mothers with singleton pregnancies from Australia’s Northern Territory Midwives’ Data Collection (2003–2005) using uni- and multivariate analyses. Groupings were by Indigenous status; region (Top End (TE)/Central Australia (CA)); Remote/ Urban residence; and across two large TE communities. Results: Of the sample, 34.1% were Indigenous women, of whom 65.6% were remote-dwelling versus 6.7% of non- Indigenous women. In comparison to CA Urban mothers: TE Remote (adjusted odds ratio [aOR] 1.47, 95%CI: 1.13, 1.90) and TE Urban mothers (aOR 1.36 (95% CI: 1.02, 1.80) were more likely, but CA Remote mothers (aOR 0.43; 95% CI: 0.31, 0.58) less likely to smoke during pregnancy; CA Remote mothers giving birth at 32 weeks gestation were less likely to have attended ≥ five antenatal visits (aOR 0.55; 95%CI: 0.36, 0.86); TE Remote (aOR 0.71; 95%CI: 0.53, 0.95