TY - JOUR
T1 - Rates of stillbirth by maternal region of birth and gestational age in New South Wales, Australia 2004–2015
AU - Berman, Ye’elah
AU - Ibiebele, Ibinabo
AU - Patterson, Jillian A.
AU - Randall, Deborah
AU - Ford, Jane B.
AU - Nippita, Tanya
AU - Morris, Jonathan M.
AU - Davies-Tuck, Miranda L.
AU - Torvaldsen, Siranda
N1 - Funding Information:
We thank the NSW Ministry of Health for access to the population health data and the NSW Centre for Health Record Linkage for linking the data sets. YB, a NSW biostatistics trainee, and ST were funded by a Prevention Research Support Grant, NSW Ministry of Health. This work was completed while YB was employed as a trainee on the NSW Biostatistics Training Program funded by the NSW Ministry of Health. She undertook this work while based at the Women and Babies Research. The funders had no role in the design and conduct of the study, collection, management, analysis, and interpretation of the data, preparation, review, or approval of the manuscript, or decision to submit the manuscript for publication.
Publisher Copyright:
© 2019 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists
PY - 2020/6
Y1 - 2020/6
N2 - Background: Research suggests that in Australia, maternal region of birth is a risk factor for stillbirth. Aims: We aimed to examine the relationship between stillbirth and maternal region of birth in New South Wales (NSW), Australia from 2004 to 2015. Methods: Adjusted logistic regression was used to determine odds of stillbirth by maternal region of birth, compared with Australian or New Zealand-born (AUS/NZ-born) women. Intervention rates (induction or pre-labour caesarean) by maternal region of birth, over time, were also examined. Interaction terms were used to assess change in relative odds of stillbirth, over two time periods (2004–2011 and 2012–2015). Results: There were 944 457 singleton births ≥24 weeks gestation that met the study inclusion criteria and 3221 of these were stillbirths, giving a stillbirth rate of 3.4 per 1000 births. After adjustment for confounders, South Asian (adjusted odds ratio (aOR) 1.42, 95% CI 1.24–1.62), Oceanian (aOR 1.45, 95% CI 1.17–1.80) and African (aOR 1.46, 96% CI 1.19–1.80) born women had significantly higher odds of stillbirth that AUS/NZ-born women. Intervention rates increased from the earlier to the later time period by 13.1% across the study population, but the increase was larger in African and South Asian-born women (18.1% and 19.6% respectively) than AUS/NZ-born women (11.2%). There was a significant interaction between ethnicity and time period for South Asian-born women in the all-births model, with their stillbirth rates becoming closer to AUS/NZ-born women in the later period. Conclusion: South Asian, African and Oceanian maternal region of birth are independent risk factors for stillbirth in NSW.
AB - Background: Research suggests that in Australia, maternal region of birth is a risk factor for stillbirth. Aims: We aimed to examine the relationship between stillbirth and maternal region of birth in New South Wales (NSW), Australia from 2004 to 2015. Methods: Adjusted logistic regression was used to determine odds of stillbirth by maternal region of birth, compared with Australian or New Zealand-born (AUS/NZ-born) women. Intervention rates (induction or pre-labour caesarean) by maternal region of birth, over time, were also examined. Interaction terms were used to assess change in relative odds of stillbirth, over two time periods (2004–2011 and 2012–2015). Results: There were 944 457 singleton births ≥24 weeks gestation that met the study inclusion criteria and 3221 of these were stillbirths, giving a stillbirth rate of 3.4 per 1000 births. After adjustment for confounders, South Asian (adjusted odds ratio (aOR) 1.42, 95% CI 1.24–1.62), Oceanian (aOR 1.45, 95% CI 1.17–1.80) and African (aOR 1.46, 96% CI 1.19–1.80) born women had significantly higher odds of stillbirth that AUS/NZ-born women. Intervention rates increased from the earlier to the later time period by 13.1% across the study population, but the increase was larger in African and South Asian-born women (18.1% and 19.6% respectively) than AUS/NZ-born women (11.2%). There was a significant interaction between ethnicity and time period for South Asian-born women in the all-births model, with their stillbirth rates becoming closer to AUS/NZ-born women in the later period. Conclusion: South Asian, African and Oceanian maternal region of birth are independent risk factors for stillbirth in NSW.
KW - birth intervention
KW - ethnicity
KW - gestational age
KW - maternal region of birth
KW - stillbirth
UR - https://www.scopus.com/pages/publications/85086005401
U2 - 10.1111/ajo.13085
DO - 10.1111/ajo.13085
M3 - Article
C2 - 32049360
AN - SCOPUS:85086005401
SN - 0004-8666
VL - 60
SP - 425
EP - 432
JO - Australian and New Zealand Journal of Obstetrics and Gynaecology
JF - Australian and New Zealand Journal of Obstetrics and Gynaecology
IS - 3
ER -