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The urban-remote divide for Indigenous perinatal outcomes.

Simon Graham1, Lisa R Jackson Pulver, Yueping Alex Wang

  • 1National Centre for Epidemiology and Population Health, College of Medicine and Health Sciences, Australian National University, Canberra, ACT, Australia.

The Medical Journal of Australia
|May 23, 2007
PubMed
Summary

Indigenous mothers in remote areas have babies with poorer perinatal outcomes. Remote residence is linked to lower "healthy baby" rates and increased risks of low birthweight and low Apgar scores, highlighting urgent equity needs.

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Area of Science:

  • Public Health
  • Perinatal Epidemiology
  • Indigenous Health

Background:

  • Geographic remoteness is a significant social determinant of health.
  • Perinatal outcomes for Indigenous populations in Australia require focused investigation.
  • Understanding the impact of residence location on Indigenous infant health is crucial.

Purpose of the Study:

  • To examine the association between the remoteness of residence and perinatal outcomes for Indigenous women's infants.
  • To identify disparities in infant health based on geographic location among Indigenous mothers.
  • To quantify the impact of remoteness on key indicators of newborn health.

Main Methods:

  • A population-based study utilizing the National Perinatal Data Collection (2001-2004).
  • Inclusion of 35,240 Indigenous mothers and 35,658 infants.
  • Analysis of outcomes including birthweight, Apgar score, stillbirth, gestational age, and a "healthy baby" composite measure based on the Australian Standard Geographical Classification remoteness categories.

Main Results:

  • Babies born in remote areas had lower odds of meeting the "healthy baby" criteria (adjusted odds ratio [AOR], 0.87; 95% CI, 0.81-0.93) compared to city births.
  • Infants from remote areas faced higher odds of low birthweight (AOR, 1.09; 95% CI, 1.01-1.19).
  • Higher odds of low Apgar scores at 5 minutes were observed for infants in remote regions (AOR, 1.63; 95% CI, 1.39-1.92).

Conclusions:

  • Only 74.9% of babies born to Indigenous mothers in remote areas qualified as "healthy babies."
  • Infants born in remote areas experienced significant disadvantages in perinatal health outcomes.
  • Urgent, concerted action is needed to address persistent perinatal inequities within the Indigenous population.