Reducing preterm birth amongst Aboriginal and Torres Strait Islander babies: A prospective cohort study, Brisbane, Australia

Kildea, S; Gao, Y; Hickey, S; Kruske, S; Nelson, C; Blackman, R; Tracy, S; Hurst, C; Williamson, D; Roe, Y

Reducing preterm birth amongst Aboriginal and Torres Strait Islander babies: A prospective cohort study, Brisbane, Australia

Kildea, S Gao, Y Hickey, S Kruske, S

Nelson, C Blackman, R Tracy, S Hurst, C Williamson, D Roe, Y

Permalink

Publication Type:: Journal Article
Citation:: EClinicalMedicine, 2019, 12 pp. 43 - 51
Issue Date:: 2019-07-01

Open Access

Copyright Clearance Process

Recently Added
In Progress
Open Access

This item is open access.

Adobe PDF

Download Published VersionAdobe PDF (473.18 kB)

View on publisher's site

View statistics

Full metadata record

Field	Value	Language
dc.contributor.author	Kildea, S	en_US
dc.contributor.author	Gao, Y	en_US
dc.contributor.author	Hickey, S	en_US
dc.contributor.author	Kruske, S https://orcid.org/0000-0002-2317-3954	en_US
dc.contributor.author	Nelson, C	en_US
dc.contributor.author	Blackman, R	en_US
dc.contributor.author	Tracy, S	en_US
dc.contributor.author	Hurst, C	en_US
dc.contributor.author	Williamson, D	en_US
dc.contributor.author	Roe, Y	en_US
dc.date.issued	2019-07-01	en_US
dc.identifier.citation	EClinicalMedicine, 2019, 12 pp. 43 - 51	en_US
dc.identifier.uri	http://hdl.handle.net/10453/135687
dc.description.abstract	© 2019 Background: Prevention of avoidable preterm birth in Aboriginal and Torres Strait Islander (Indigenous) families is a major public health priority in Australia. Evidence about effective, scalable strategies to improve maternal and infant outcomes is urgently needed. In 2013, a multiagency partnership between two Aboriginal Community Controlled Health Organisations and a tertiary maternity hospital co-designed a new service aimed at reducing preterm birth: ‘Birthing in Our Community’. Methods: A prospective interventional cohort study compared outcomes for women with an Indigenous baby receiving care through a new service (n = 461) to women receiving standard care (n = 563), January 2013–December 2017. The primary outcome was preterm birth (< 37 weeks gestation). One to one propensity score matching was used to select equal sized standard care and new service cohorts with similar distribution of characteristics. Conditional logistic regression calculated the odds ratio with matched samples. Findings: Women receiving the new service were less likely to give birth to a preterm infant than women receiving standard care (6·9% compared to 11.6%). After controlling for confounders, the new service significantly reduced the odds of having a preterm birth (unmatched, n = 1024: OR = 0·57, 95% CI 0·37, 0·89; matched, n = 690: OR = 0·50, 95% CI 0·31, 0·83). Interpretation: The short-term results of this service redesign send a strong signal that the preterm birth gap can be reduced through targeted interventions that increase Indigenous governance of, and workforce in, maternity services and provide continuity of midwifery carer, an integrated approach to supportive family services and a community-based hub.	en_US
dc.relation.ispartof	EClinicalMedicine	en_US
dc.relation.isbasedon	10.1016/j.eclinm.2019.06.001	en_US
dc.title	Reducing preterm birth amongst Aboriginal and Torres Strait Islander babies: A prospective cohort study, Brisbane, Australia	en_US
dc.type	Journal Article
utslib.citation.volume	12	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access
pubs.publication-status	Published	en_US
pubs.volume	12	en_US

Abstract:

© 2019 Background: Prevention of avoidable preterm birth in Aboriginal and Torres Strait Islander (Indigenous) families is a major public health priority in Australia. Evidence about effective, scalable strategies to improve maternal and infant outcomes is urgently needed. In 2013, a multiagency partnership between two Aboriginal Community Controlled Health Organisations and a tertiary maternity hospital co-designed a new service aimed at reducing preterm birth: ‘Birthing in Our Community’. Methods: A prospective interventional cohort study compared outcomes for women with an Indigenous baby receiving care through a new service (n = 461) to women receiving standard care (n = 563), January 2013–December 2017. The primary outcome was preterm birth (< 37 weeks gestation). One to one propensity score matching was used to select equal sized standard care and new service cohorts with similar distribution of characteristics. Conditional logistic regression calculated the odds ratio with matched samples. Findings: Women receiving the new service were less likely to give birth to a preterm infant than women receiving standard care (6·9% compared to 11.6%). After controlling for confounders, the new service significantly reduced the odds of having a preterm birth (unmatched, n = 1024: OR = 0·57, 95% CI 0·37, 0·89; matched, n = 690: OR = 0·50, 95% CI 0·31, 0·83). Interpretation: The short-term results of this service redesign send a strong signal that the preterm birth gap can be reduced through targeted interventions that increase Indigenous governance of, and workforce in, maternity services and provide continuity of midwifery carer, an integrated approach to supportive family services and a community-based hub.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/135687