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https://hdl.handle.net/2440/136875
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Type: | Journal article |
Title: | Early mortality among Aboriginal and non-Aboriginal women who had a preterm birth in Western Australia: A population-based cohort study |
Author: | Bailey, H.D. Gray, C. Adane, A.A. Strobel, N.A. White, S.W. Marriott, R. Tessema, G.A. Shepherd, C.C.J. Sharp, M. |
Citation: | Paediatric and Perinatal Epidemiology, 2022; 37(1):1-14 |
Publisher: | Wiley |
Issue Date: | 2022 |
ISSN: | 0269-5022 1365-3016 |
Statement of Responsibility: | Helen D. Bailey, Caitlin Gray, Akilew A. Adane, Natalie A. Strobel, Scott W. White, Rhonda Marriott, Gizachew A. Tessema, Carrington C. J. Shepherd, Mary Sharp |
Abstract: | Background: Having a preterm (<37 weeks' gestation) birth may increase a woman's risk of early mortality. Aboriginal and Torres Strait Islander (hereafter Aboriginal) women have higher preterm birth and mortality rates compared with other Australian women. Objectives: We investigated whether a history of having a preterm birth was associated with early mortality in women and whether these associations differed by Aboriginal status. Methods: This retrospective cohort study used population-based perinatal records of women who had a singleton birth between 1980 and 2015 in Western Australia linked to Death Registry data until June 2018. The primary and secondary outcomes were all-cause and cause-specific mortality respectively. After stratification by Aboriginal status, rate differences were calculated, and Cox proportional hazard regression was used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for allcause and cause-specific mortality. Results: There were 20,244 Aboriginal mothers (1349 deaths) and 457,357 nonAboriginal mothers (7646 deaths) with 8.6 million person-years of follow-up. The all-cause mortality rates for Aboriginal mothers who had preterm births and term births were 529.5 and 344.0 (rate difference 185.5, 95% CI 135.5, 238.5) per 100,000 person-years respectively. Among non-Aboriginal mothers, the corresponding figures were 125.5 and 88.6 (rate difference 37.0, 95% CI 29.4, 44.9) per 100,000 personyears. The HR for all-cause mortality for Aboriginal and non-Aboriginal mothers associated with preterm birth were 1.48 (95% CI 1.32, 1.66) and 1.35 (95% CI 1.26, 1.44), respectively, compared with term birth. Compared with mothers who had term births, mothers of preterm births had higher relative risks of mortality from diabetes, cardiovascular, digestive and external causes. Conclusions: Both Aboriginal and non-Aboriginal women who had a preterm birth had a moderately increased risk of mortality up to 38 years after the birth, reinforcing the importance of primary prevention and ongoing screening. |
Keywords: | Aboriginal; birth; data linkage; mortality; preterm; Western Australia; women |
Rights: | © 2022 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
DOI: | 10.1111/ppe.12929 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/GNT1127265 |
Published version: | http://dx.doi.org/10.1111/ppe.12929 |
Appears in Collections: | Public Health publications |
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