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Huda MM, Callaway LK, Jackson G, Fatima Y, Cumming J, Biswas T, Paz GR, Boyle F, Sly PD, Mamun AA. Time trends, projections, and spatial distribution of low birthweight in Australia, 2009-2030: Evidence from the National Perinatal Data Collection. Birth 2023; 50:76-89. [PMID: 36696404 PMCID: PMC10947513 DOI: 10.1111/birt.12708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 11/15/2022] [Accepted: 01/06/2023] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Infants with low birthweight (LBW, birthweight <2500 g) have increased in many high-resource countries over the past two decades. This study aimed to investigate the time trends, projections, and spatial distribution of LBW in Australia, 2009-2030. METHODS We used standard aggregate data on 3 346 808 births from 2009 to 2019 from Australia's National Perinatal Data Collection. Bayesian linear regression model was used to estimate the trends in the prevalence of LBW in Australia. RESULTS Wefound that the prevalence of LBW was 6.18% in 2009, which has increased to 6.64% in 2019 (average annual rate of change, AARC = +0.76%). If the national trend remains the same, the projected prevalence of LBW in Australia will increase to 7.34% (95% uncertainty interval, UI = 6.99, 7.68) in 2030. Observing AARC across different subpopulations, the trend of LBW was stable among Indigenous mothers, whereas it increased among non-Indigenous mothers (AARC = +0.81%). There is also an increase among the most disadvantaged mothers (AARC = +1.08%), birthing people in either of two extreme age groups (AARC = +1.99% and +1.53% for <20 years and ≥40 years, respectively), and mothers who smoked during pregnancy (AARC = +1.52%). Spatiotemporal maps showed that some of the Statistical Area level 3 (SA3) in Northern Territory and Queensland had consistently higher prevalence for LBW than the national average from 2014 to 2019. CONCLUSION Overall, the prevalence of LBW has increased in Australia during 2009-2019; however, the trends vary across different subpopulations. If trends persist, Australia will not achieve the Sustainable Development Goals (SDGs) target of a 30% reduction in LBW by 2030. Centering and supporting the most vulnerable subpopulations is vital to progress the SDGs and improves perinatal and infant health in Australia.
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Affiliation(s)
- M. Mamun Huda
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
| | - Leonie K. Callaway
- Women's and Newborn ServicesRoyal Brisbane and Women's HospitalQueenslandBrisbaneAustralia
- Faculty of MedicineThe University of QueenslandBrisbaneAustralia
| | - Greg Jackson
- Health Protection Branch, Queensland Department of HealthQueenslandBrisbaneAustralia
- Queensland Alliance for Environmental Health Sciences (QAEHS)The University of QueenslandQueenslandWoolloongabbaAustralia
| | - Yaqoot Fatima
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
- Murtupuni Centre for Rural and Remote HealthJames Cook UniversityQueenslandMount IsaAustralia
| | - Janet Cumming
- Health Protection Branch, Queensland Department of HealthQueenslandBrisbaneAustralia
| | - Tuhin Biswas
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
- Science and Math ProgramAsian University for WomenChattogramBangladesh
| | - Gonzalo R. Paz
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
- Facultad de MedicinaUniversidad del ValleCaliColombia
| | - Fran Boyle
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
| | - Peter D. Sly
- Children's Health Research CentreUniversity of QueenslandSouth BrisbaneAustralia
- WHO Collaborating Centre for Children's Health and EnvironmentQueenslandSouth BrisbaneAustralia
| | - Abdullah Al Mamun
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
- Queensland Alliance for Environmental Health Sciences (QAEHS)The University of QueenslandQueenslandWoolloongabbaAustralia
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Selvaratnam RJ, Wallace EM, Wolfe R, Anderson PJ, Davey MA. Association Between Iatrogenic Delivery for Suspected Fetal Growth Restriction and Childhood School Outcomes. JAMA 2021; 326:145-153. [PMID: 34255007 PMCID: PMC8278267 DOI: 10.1001/jama.2021.8608] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Timely delivery of infants suspected of having fetal growth restriction (FGR) is a balance between preventing stillbirth and minimizing prematurity, particularly because many infants with suspected FGR have normal growth. OBJECTIVE To explore the association between iatrogenic delivery for suspected FGR and childhood school outcomes. DESIGN, SETTING, AND PARTICIPANTS A retrospective whole-population cohort study linking perinatal data from births 32 weeks' or more gestation between January 1, 2003, to December 31, 2013, to developmental and educational test scores at preparatory school, and at school grades 3, 5, and 7 in Victoria, Australia. Follow-up was concluded in 2019. EXPOSURES Suspicion or nonsuspicion of FGR, presence or absence of iatrogenic delivery (defined as early induction of labor or cesarean delivery prior to labor) for suspected FGR, and presence or absence of small for gestational age (SGA). MAIN OUTCOMES AND MEASURES The coprimary outcomes were being in the bottom 10th percentile on 2 or more of 5 developmental domains at school entry and being below the national minimum standard on 2 or more of 5 educational domains in grades 3, 5, or 7. RESULTS In the birth population of 705 937 infants, the mean gestation at birth was 39.1 (SD, 1.5) weeks and the mean birth weight was 3426 (SD, 517) grams. The birth population linked to 181 902 children with developmental results and 425 717 children with educational results. Compared with infants with severe SGA (birth weight <3rd percentile) not suspected of having FGR, infants with severe SGA delivered for suspected FGR were born earlier (mean gestation, 37.9 weeks vs 39.4 weeks). They also had a significantly increased risk of poor developmental outcome at school entry (16.2% vs 12.7%; absolute difference, 3.5% [95% CI, 0.5%-6.5%]); adjusted odds ratio [aOR], 1.36 [95% CI, 1.07-1.74]) and poor educational outcomes in grades 3, 5, and 7 (for example, in grade 7: 13.4% vs 10.5%; absolute difference, 2.9% [95% CI, 0.4%-5.5%]); aOR, 1.33 [95% CI, 1.04-1.70]). There was no significant difference between infants with normal growth (birth weight ≥10th percentile) delivered for suspected FGR and those not suspected of having FGR in developmental outcome (8.6% vs 8.1%; absolute difference, 0.5% [95% CI, -1.1% to 2.0%]); aOR, 1.17 [95% CI, 0.95-1.45]) or educational outcome in grade 3, 5 or 7, despite being born earlier (mean gestation, 38.0 weeks vs 39.1 weeks). CONCLUSIONS AND RELEVANCE In this exploratory study conducted in Victoria, Australia, iatrogenic delivery of infants with severe SGA due to suspected FGR was associated with poorer school outcomes compared with infants with severe SGA not suspected of having FGR. Iatrogenic delivery of infants with normal growth due to suspected FGR was not associated with poorer school outcomes compared with infants with normal growth not suspected of having FGR.
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Affiliation(s)
- Roshan John Selvaratnam
- The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
- Safer Care Victoria, Department of Health, Victorian Government, Victoria, Australia
| | - Euan Morrison Wallace
- The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
- Safer Care Victoria, Department of Health, Victorian Government, Victoria, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter John Anderson
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Mary-Ann Davey
- The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
- Safer Care Victoria, Department of Health, Victorian Government, Victoria, Australia
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Baumgartel K, Jensen L, White SW, Wong K, Straker L, Leonard H, Finlay-Jones A, Downs J. The contributions of fetal growth restriction and gestational age to developmental outcomes at 12 months of age: A cohort study. Early Hum Dev 2020; 142:104951. [PMID: 31945660 DOI: 10.1016/j.earlhumdev.2020.104951] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 12/24/2019] [Accepted: 01/02/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Preterm birth is a known risk factor for infant development but it is less clear whether fetal growth restriction (FGR) and early term birth between 37 and 39 weeks gestation are associated with risks for infant development. AIMS This study investigated risk factors for adverse developmental outcomes at 12 months of age in a population-based birth cohort. STUDY DESIGN Cohort study. SUBJECTS Participants in the Raine Study, which recruited 2900 women at 18 weeks of gestation (Gen1) and followed up infants longitudinally (Gen2). At 12 months, 1773 mothers provided developmental data for their infants. OUTCOME MEASURE The Ages and Stages Questionnaire (ASQ) was used to measure gross and fine motor, communication, adaptability and personal social development. Multivariate logistic regression analyses were used to estimate associations between FGR, gestational age, sex, breast feeding, parental age, socioeconomic factors and developmental delay at 12 months of age as measured with the ASQ. RESULTS The risk of any delay at 12 months of age, as well as gross motor, fine motor and adaptive delay, was slightly increased for infants born FGR. Preterm and early term birth and male sex were associated with poorer development at 12 months. Breast feeding was protective of developmental status. CONCLUSIONS Developmental assessment using the ASQ of infants with FGR was mostly comparable to those born without FGR at 12 months, although finer-grained neurobehavioural assessments may yield capacity for earlier identification of developmental risk. Our data provide weight to the argument that surveillance of early term infants could enable earlier intervention for children at risk.
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Affiliation(s)
- Katelyn Baumgartel
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Lynn Jensen
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Scott W White
- Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Western Australia, Australia; Maternal Fetal Medicine Service, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Kingsley Wong
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Helen Leonard
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Amy Finlay-Jones
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Jenny Downs
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia; Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
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Abdullahi I, Wong K, Glasson E, Mutch R, de Klerk N, Downs J, Cherian S, Leonard H. Are preterm birth and intra-uterine growth restriction more common in Western Australian children of immigrant backgrounds? A population based data linkage study. BMC Pregnancy Childbirth 2019; 19:287. [PMID: 31399075 PMCID: PMC6688266 DOI: 10.1186/s12884-019-2437-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 07/29/2019] [Indexed: 11/22/2022] Open
Abstract
Background To compare the prevalence of preterm birth, post term birth, intra-uterine growth restriction and distribution of Apgar scores in offspring of foreign-born women in Western Australia with that of their Australian-born non-Indigenous and Indigenous counterparts. Methods A population-based linked data study, involving 767,623 singleton births in Western Australia between 1980 and 2010 was undertaken. Neonatal outcomes included preterm birth, post term births, intra-uterine growth restriction (assessed using the proportion of optimal birth weight) and low Apgar scores. These were compared amongst foreign-born women from low, lower-middle, upper middle and high income countries and Australian-born non-Indigenous and Indigenous women over two different time periods using multinomial logistic regression adjusted for covariates. Results Compared with Australian born non-Indigenous women, foreign-born women from low income countries were at some increased risk of extreme preterm (aRRR 1.59, 95% CI 0.87, 2.89) and very early preterm (aRRR 1.63, 95% CI 0.92, 2.89) births during the period from 1980 to 1996. During the period from 1997 to 2010 they were also at some risk of extreme preterm (aRRR 1.42, 95% CI 0.98, 2.04) very early preterm (aRRR 1.34, 95% CI 1.11, 1.62) and post term birth (aRRR 1.93, 95% CI 0.99, 3.78). During this second time period, other adverse outcomes for children of foreign-born women from low income and middle income countries included increases in severe (aRRR 1.69, 95% CI 1.30, 2.20; aRRR 1.72, 95% CI 1.53, 1.93), moderate (aRRR 1.54, 95% CI 1.32, 1.81; aRRR 1.59, 95% CI 1.48, 1.70) and mild (aRRR 1.28, 95% CI 1.14, 1.43; aRRR 1.31, 95% CI 1.25, 1.38) IUGR compared to children of Australian-born non-Indigenous mothers. Uniformly higher risks of adverse outcomes were also demonstrated for infants of Indigenous mothers. Conclusions Our findings illustrate the vulnerabilities of children born to foreign women from low and middle-income countries. The need for exploratory research examining mechanisms contributing to poorer birth outcomes following resettlement in a developed nation is highlighted. There is also a need to develop targeted interventions to improve outcomes for these women and their families. Electronic supplementary material The online version of this article (10.1186/s12884-019-2437-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ifrah Abdullahi
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.,School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia
| | - Kingsley Wong
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia
| | - Emma Glasson
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia
| | - Raewyn Mutch
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.,School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Department of General Paediatrics, Perth Children's Hospital, Perth, WA, Australia
| | - Nicholas de Klerk
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia
| | - Jenny Downs
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Sarah Cherian
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Department of General Paediatrics, Perth Children's Hospital, Perth, WA, Australia
| | - Helen Leonard
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.
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Hunter DS, Hazel SJ, Kind KL, Liu H, Marini D, Giles LC, De Blasio MJ, Owens JA, Pitcher JB, Gatford KL. Effects of induced placental and fetal growth restriction, size at birth and early neonatal growth on behavioural and brain structural lateralization in sheep. Laterality 2016; 22:560-589. [PMID: 27759494 DOI: 10.1080/1357650x.2016.1243552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Poor perinatal growth in humans results in asymmetrical grey matter loss in fetuses and infants and increased functional and behavioural asymmetry, but specific contributions of pre- and postnatal growth are unclear. We therefore compared strength and direction of lateralization in obstacle avoidance and maze exit preference tasks in offspring of placentally restricted (PR: 10M, 13F) and control (CON: 23M, 17F) sheep pregnancies at 18 and 40 weeks of age, and examined gross brain structure of the prefrontal cortex at 52 weeks of age (PR: 14M, 18F; CON: 23M, 25F). PR did not affect lateralization direction, but 40-week-old PR females had greater lateralization strength than CON (P = .021). Behavioural lateralization measures were not correlated with perinatal growth. PR did not alter brain morphology. In males, cross-sectional areas of the prefrontal cortex and left hemisphere correlated positively with skull width at birth, and white matter area correlated positively with neonatal growth rate of the skull (all P < .05). These studies reinforce the need to include progeny of both sexes in future studies of neurodevelopmental programming, and suggest that restricting in utero growth has relatively mild effects on gross brain structural or behavioural lateralization in sheep.
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Affiliation(s)
- Damien Seth Hunter
- a Robinson Research Institute , North Adelaide , Australia.,b Discipline of Obstetrics and Gynaecology, Adelaide Medical School , Adelaide , Australia.,c School of Animal and Veterinary Sciences , Adelaide , South Australia , Australia
| | - Susan J Hazel
- c School of Animal and Veterinary Sciences , Adelaide , South Australia , Australia
| | - Karen L Kind
- a Robinson Research Institute , North Adelaide , Australia.,c School of Animal and Veterinary Sciences , Adelaide , South Australia , Australia
| | - Hong Liu
- a Robinson Research Institute , North Adelaide , Australia.,b Discipline of Obstetrics and Gynaecology, Adelaide Medical School , Adelaide , Australia
| | - Danila Marini
- c School of Animal and Veterinary Sciences , Adelaide , South Australia , Australia
| | - Lynne C Giles
- a Robinson Research Institute , North Adelaide , Australia.,d School of Population Health , University of Adelaide , Adelaide , South Australia , Australia
| | - Miles J De Blasio
- a Robinson Research Institute , North Adelaide , Australia.,b Discipline of Obstetrics and Gynaecology, Adelaide Medical School , Adelaide , Australia
| | - Julie A Owens
- a Robinson Research Institute , North Adelaide , Australia.,b Discipline of Obstetrics and Gynaecology, Adelaide Medical School , Adelaide , Australia
| | - Julia B Pitcher
- a Robinson Research Institute , North Adelaide , Australia.,b Discipline of Obstetrics and Gynaecology, Adelaide Medical School , Adelaide , Australia
| | - Kathryn L Gatford
- a Robinson Research Institute , North Adelaide , Australia.,b Discipline of Obstetrics and Gynaecology, Adelaide Medical School , Adelaide , Australia
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Hunter DS, Hazel SJ, Kind KL, Owens JA, Pitcher JB, Gatford KL. Programming the brain: Common outcomes and gaps in knowledge from animal studies of IUGR. Physiol Behav 2016; 164:233-48. [DOI: 10.1016/j.physbeh.2016.06.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/06/2016] [Accepted: 06/06/2016] [Indexed: 12/18/2022]
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Miller JE, Hammond GC, Strunk T, Moore HC, Leonard H, Carter KW, Bhutta Z, Stanley F, de Klerk N, Burgner DP. Association of gestational age and growth measures at birth with infection-related admissions to hospital throughout childhood: a population-based, data-linkage study from Western Australia. THE LANCET. INFECTIOUS DISEASES 2016; 16:952-61. [DOI: 10.1016/s1473-3099(16)00150-x] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/12/2016] [Accepted: 03/03/2016] [Indexed: 11/26/2022]
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Falster K, Jorm L, Eades S, Lynch J, Banks E, Brownell M, Craven R, Einarsdóttir K, Randall D. What factors contribute to positive early childhood health and development in Australian Aboriginal children? Protocol for a population-based cohort study using linked administrative data (The Seeding Success Study). BMJ Open 2015; 5:e007898. [PMID: 25986640 PMCID: PMC4442193 DOI: 10.1136/bmjopen-2015-007898] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Australian Aboriginal children are more likely than non-Aboriginal children to have developmental vulnerability at school entry that tracks through to poorer literacy and numeracy outcomes and multiple social and health disadvantages in later life. Empirical evidence identifying the key drivers of positive early childhood development in Aboriginal children, and supportive features of local communities and early childhood service provision, are lacking. METHODS AND ANALYSIS The study population will be identified via linkage of Australian Early Development Census data to perinatal and birth registration data sets. It will include an almost complete population of children who started their first year of full-time school in New South Wales (NSW), Australia, in 2009 and 2012. Early childhood health and development trajectories for these children will be constructed via linkage to a range of administrative data sets relating to birth outcomes, congenital conditions, hospital admissions, emergency department presentations, receipt of ambulatory mental healthcare services, use of general practitioner services, contact with child protection and out-of-home care services, receipt of income assistance and fact of death. Using multilevel modelling techniques, we will quantify the contributions of individual-level and area-level factors to variation in early childhood development outcomes in Aboriginal and non-Aboriginal children. Additionally, we will evaluate the impact of two government programmes that aim to address early childhood disadvantage, the NSW Aboriginal Maternal and Infant Health Service and the Brighter Futures Program. These evaluations will use propensity score matching methods and multilevel modelling. ETHICS AND DISSEMINATION Ethical approval has been obtained for this study. Dissemination mechanisms include engagement of stakeholders (including representatives from Aboriginal community controlled organisations, policy agencies, service providers) through a reference group, and writing of summary reports for policy and community audiences in parallel with scientific papers.
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Affiliation(s)
- Kathleen Falster
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
- The Sax Institute, Sydney, Australia
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
- Centre for Health Research, School of Medicine, University of Western Sydney, Campbelltown, Australia
| | - Sandra Eades
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - John Lynch
- School of Population Health, University of Adelaide, Adelaide, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
- The Sax Institute, Sydney, Australia
| | - Marni Brownell
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada
| | - Rhonda Craven
- Institute of Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | | | - Deborah Randall
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
- Centre for Health Research, School of Medicine, University of Western Sydney, Campbelltown, Australia
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Wahi G, Wilson J, Miller R, Anglin R, McDonald S, Morrison KM, Teo KK, Anand SS. Aboriginal birth cohort (ABC): a prospective cohort study of early life determinants of adiposity and associated risk factors among Aboriginal people in Canada. BMC Public Health 2013; 13:608. [PMID: 23800270 PMCID: PMC3702421 DOI: 10.1186/1471-2458-13-608] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 06/19/2013] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Aboriginal people living in Canada have a high prevalence of obesity, type 2 diabetes, and cardiovascular disease (CVD). To better understand the pre and postnatal influences on the development of adiposity and related cardio-metabolic factors in adult Aboriginal people, we will recruit and follow prospectively Aboriginal pregnant mothers and their children - the Aboriginal Birth Cohort (ABC) study. METHODS/DESIGN We aim to recruit 300 Aboriginal pregnant mothers and their newborns from the Six Nations Reserve, and follow them prospectively to age 3 years. Key details of environment and health including maternal nutrition, glucose tolerance, physical activity, and weight gain will be collected. At birth, cord blood and placenta samples will be collected, as well as newborn anthropometric measurements. Mothers and offspring will be followed annually with serial measurements of diet and physical activity, growth trajectory, and adiposity. DISCUSSION There is an urgent need to understand maternal and child factors that underlie the early development of adiposity and type 2 diabetes in Aboriginal people. The information generated from this cohort will assist the Six Nations community in developing interventions to prevent early adiposity in Aboriginal children.
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Affiliation(s)
- Gita Wahi
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - Julie Wilson
- Six Nations Health Services, 1745 Chiefswood Rd, Ohsweken, ON N0A 1M0, Canada
| | - Ruby Miller
- Six Nations Health Services, 1745 Chiefswood Rd, Ohsweken, ON N0A 1M0, Canada
| | - Rebecca Anglin
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - Sarah McDonald
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - Katherine M Morrison
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada
| | - Koon K Teo
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada
| | - Sonia S Anand
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada
- Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Canada
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Socioeconomic status accounts for rapidly increasing geographic variation in the incidence of poor fetal growth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:2606-20. [PMID: 23799513 PMCID: PMC3734446 DOI: 10.3390/ijerph10072606] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 06/03/2013] [Accepted: 06/12/2013] [Indexed: 12/03/2022]
Abstract
Fetal growth is an important risk factor for infant morbidity and mortality. In turn, socioeconomic status is a key predictor of fetal growth; however, other sociodemographic factors and environmental effects may also be important. This study modelled geographic variation in poor fetal growth after accounting for socioeconomic status, with a fixed effect for socioeconomic status and a combination of spatially-correlated and spatially-uncorrelated random effects. The dataset comprised 88,246 liveborn singletons, aggregated within suburbs in Perth, Western Australia. Low socioeconomic status was strongly associated with an increased risk of poor fetal growth. An increase in geographic variation of poor fetal growth from 1999–2001 (interquartile odds ratio among suburbs = 1.20) to 2004–2006 (interquartile odds ratio = 1.40) indicated a widening risk disparity by socioeconomic status. Low levels of residual spatial patterns strengthen the case for targeting policies and practices in areas of low socioeconomic status for improved outcomes. This study indicates an alarming increase in geographic inequalities in poor fetal growth in Perth which warrants further research into the specific aspects of socioeconomic status that act as risk factors.
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Glinianaia SV, Ghosh R, Rankin J, Pearce MS, Parker L, Pless-Mulloli T. No improvement in socioeconomic inequalities in birthweight and preterm birth over four decades: a population-based cohort study. BMC Public Health 2013; 13:345. [PMID: 23587186 PMCID: PMC3651338 DOI: 10.1186/1471-2458-13-345] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Accepted: 04/09/2013] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Birthweight and gestational age are associated with socioeconomic deprivation, but the evidence in relation to temporal changes in these associations is sparse. We investigated changes in the associations between socioeconomic status (SES) and birthweight and gestational age in Newcastle upon Tyne, North of England, during 1961-2000. METHODS We used population-based data from hospital neonatal records on all singleton births to mothers resident in Newcastle (births with complete covariate information n = 113,182). We used linear regression to analyse the associations between neighbourhood SES and birthweight over the entire 40-year period and by decade, and logistic regression for associations with low birthweight (LBW) and preterm birth, adjusting for potential confounders. RESULTS There was a significant interaction between SES and decade of birth for birthweight (p = 0.028) and preterm birth (p < 0.001). Socioeconomic gradients were similar in each decade for birthweight outcomes, but for preterm birth, socioeconomic disparities were more evident in the later decades [for 1961-70, odds ratio (OR) was 1.1, 95% CI 0.9, 1.3, for the most deprived versus the least deprived quartile, while for 1991-2000, the corresponding OR was 1.5, 95% CI 1.3, 1.7]. In each decade, there was a significant decrease in birthweight adjusted for gestational age for the most deprived compared to the least deprived SES group [1961-1970: -113.4 g (95% CI-133.0, -93.8); 1991-2000: -97.5 g (95% CI-113.0, -82.0)], while there was a significant increase in birthweight in each SES group over time. CONCLUSIONS Socioeconomic inequalities did not narrow over the four decades for birthweight and widened for preterm birth. Mean birthweight adjusted for gestational age increased in all socioeconomic groups, suggesting an overall increase in fetal growth.
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Affiliation(s)
- Svetlana V Glinianaia
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, England, UK
- Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - Rakesh Ghosh
- Department of Public Health Sciences, University of California, Davis, USA
| | - Judith Rankin
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, England, UK
| | - Mark S Pearce
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, England, UK
| | - Louise Parker
- Departments of Medicine and Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Tanja Pless-Mulloli
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, England, UK
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