Brown, Kiarna

Cotaru, Carina

Binks, Michael

2024-01-05

BACKGROUND: Preterm birth (PTB) is the single most important cause of perinatal mortality and morbidity in high income countries. In Australia, 8.6% of babies are born preterm but substantial variability exists between States and Territories. Previous reports suggest PTB rates are highest in the Northern Territory (NT), but comprehensive analysis of trends and risk factors are lacking in this region. The objective of this study was to characterise temporal trends in PTB among First Nations and non-First Nations mothers in the Top End of the NT over a 10-year period and to identify perinatal factors associated with the risk of PTB. METHODS: This was a retrospective population-based cohort study of all births in the Top End of the NT over the 10-year period from January 1st, 2008, to December 31st, 2017. We described maternal characteristics, obstetric complications, birth characteristics and annual trends in PTB. The association between the characteristics and the risk of PTB was determined using univariate and multivariate generalised linear models producing crude risk ratios (cRR) and adjusted risk ratios (aRR). Data were analysed overall, in First Nations and non-First Nations women. RESULTS: During the decade ending in 2017, annual rates of PTB in the Top End of the NT remained consistently close to 10% of all live births. However, First Nations women experienced more than twice the risk of PTB (16%) compared to other women (7%). Leading risk factors for PTB among First Nations women as compared to other women included premature rupture of membranes (RR 12.33; 95% CI 11.78, 12.90), multiple pregnancy (RR 7.24; 95% CI 6.68, 7.83), antepartum haemorrhage (RR 4.36; 95% CI 3.93, 4.84) and pre-existing diabetes (RR 4.18; 95% CI 3.67, 4.76). CONCLUSIONS: First Nations women experience some of the highest PTB rates globally. Addressing specific pregnancy complications provides avenues for intervention, but the story is complex and deeper exploration is warranted. A holistic approach that also acknowledges the influence of socio-demographic influences, such as remote dwelling and disadvantage on disease burden, will be required to improve perinatal outcomes.

Menzies School of Health Research, Royal Darwin Hospital, Building 58, John Matthews Building, Tiwi, NT, 0810, Australia. Kiarna.brown@menzies.edu.au.

Department of Obstetrics and Gynaecology, Royal Darwin Hospital, Darwin, NT, Australia. Kiarna.brown@menzies.edu.au.

Department of Obstetrics and Gynaecology, Royal Darwin Hospital, Darwin, NT, Australia.

Menzies School of Health Research, Royal Darwin Hospital, Building 58, John Matthews Building, Tiwi, NT, 0810, Australia.

BMC Pregnancy Childbirth. 2024 Jan 5;24(1):33. doi: 10.1186/s12884-023-06164-6.

0000-0001-5100-6398

https://pubmed.ncbi.nlm.nih.gov/38182975/?otool=iaurydwlib

https://hdl.handle.net/10137/12620

24

Infant, Newborn

Infant

Pregnancy

Female

Humans

Cohort Studies

Longitudinal Studies

Retrospective Studies

Northern Territory/epidemiology

*Premature Birth/epidemiology

Risk Factors

Mothers

A retrospective, longitudinal cohort study of trends and risk factors for preterm birth in the Northern Territory, Australia.

Journal Article

Publication