Gestational age specific stillbirth risk among Indigenous and non-Indigenous women in Queensland, Australia: a population based study.

Change log
Ibiebele, Ibinabo 
Coory, Michael 
Smith, Gordon CS 
Boyle, Frances M 
Vlack, Susan 

BACKGROUND: In Australia, significant disparity persists in stillbirth rates between Aboriginal and Torres Strait Islander (Indigenous Australian) and non-Indigenous women. Diabetes, hypertension, antepartum haemorrhage and small-for-gestational age (SGA) have been identified as important contributors to higher rates among Indigenous women. The objective of this study was to examine gestational age specific risk of stillbirth associated with these conditions among Indigenous and non-Indigenous women. METHODS: Retrospective population-based study of all singleton births of at least 20 weeks gestation or at least 400 grams birthweight in Queensland between July 2005 and December 2011 using data from the Queensland Perinatal Data Collection, which is a routinely-maintained database that collects data on all births in Queensland. Multivariate logistic regression was used to calculate adjusted odds ratios (aOR) and 95 % confidence intervals, adjusting for maternal demographic and pregnancy factors. RESULTS: Of 360987 births analysed, 20273 (5.6 %) were to Indigenous women and 340714 (94.4 %) were to non-Indigenous women. Stillbirth rates were 7.9 (95 % CI 6.8-9.2) and 4.1 (95 % CI 3.9-4.3) per 1000 births, respectively. For both Indigenous and non-Indigenous women across most gestational age groups, antepartum haemorrhage, SGA, pre-existing diabetes and pre-existing hypertension were associated with increased risk of stillbirth. There were mixed results for pre-eclampsia and eclampsia and a consistently raised risk of stillbirth was not seen for gestational diabetes. CONCLUSION: This study highlights gestational age specific stillbirth risk for Indigenous and non-Indigenous women; and disparity in risk at term gestations. Improving access to and utilisation of appropriate and responsive healthcare may help to address disparities in stillbirth risk for Indigenous women.

Aboriginal and Torres Strait Islander Australians, Antepartum haemorrhage, Diabetes, Fetal death, Hypertension, Indigenous, Risk, Small for gestational age, Stillbirth, Adolescent, Adult, Diabetes Mellitus, Diabetes, Gestational, Female, Gestational Age, Humans, Hypertension, Infant, Small for Gestational Age, Native Hawaiian or Other Pacific Islander, Pre-Eclampsia, Pregnancy, Queensland, Retrospective Studies, Risk Factors, Stillbirth, Uterine Hemorrhage, Young Adult
Journal Title
BMC Pregnancy Childbirth
Conference Name
Journal ISSN
Volume Title
Springer Science and Business Media LLC
Ibinabo Ibiebele is a recipient of the National Health and Medical Research Council Postgraduate Public Health scholarship and the University of Queensland Research Scholarship.