Rates of stillbirth by maternal region of birth and gestational age in New South Wales, Australia 2004–2015

Background Research suggests that in Australia, maternal region of birth is a risk factor for stillbirth. Aims We aimed to examine the relationship between stillbirth and maternal region of birth in New South Wales (NSW), Australia from 2004 to 2015. Methods Adjusted logistic regression was used to...

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Vydané v:	Australian & New Zealand journal of obstetrics & gynaecology Ročník 60; číslo 3; s. 425 - 432
Hlavní autori:	Berman, Ye’elah, Ibiebele, Ibinabo, Patterson, Jillian A., Randall, Deborah, Ford, Jane B., Nippita, Tanya, Morris, Jonathan M., Davies‐Tuck, Miranda L., Torvaldsen, Siranda
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Australia 01.06.2020
Predmet:	Adult Africa - epidemiology Asia - epidemiology Asian People - statistics & numerical data birth intervention Black People - statistics & numerical data ethnicity Ethnicity - statistics & numerical data Female Gestational Age Humans Logistic Models maternal region of birth New South Wales - epidemiology New Zealand - epidemiology Odds Ratio Pregnancy Risk Factors stillbirth Stillbirth - epidemiology Young Adult New Zealand New South Wales Asia Africa stillbirth gestational age birth intervention ethnicity maternal region of birth
ISSN:	0004-8666, 1479-828X, 1479-828X
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Abstract	Background Research suggests that in Australia, maternal region of birth is a risk factor for stillbirth. Aims We aimed to examine the relationship between stillbirth and maternal region of birth in New South Wales (NSW), Australia from 2004 to 2015. Methods Adjusted logistic regression was used to determine odds of stillbirth by maternal region of birth, compared with Australian or New Zealand‐born (AUS/NZ‐born) women. Intervention rates (induction or pre‐labour caesarean) by maternal region of birth, over time, were also examined. Interaction terms were used to assess change in relative odds of stillbirth, over two time periods (2004–2011 and 2012–2015). Results There were 944 457 singleton births ≥24 weeks gestation that met the study inclusion criteria and 3221 of these were stillbirths, giving a stillbirth rate of 3.4 per 1000 births. After adjustment for confounders, South Asian (adjusted odds ratio (aOR) 1.42, 95% CI 1.24–1.62), Oceanian (aOR 1.45, 95% CI 1.17–1.80) and African (aOR 1.46, 96% CI 1.19–1.80) born women had significantly higher odds of stillbirth that AUS/NZ‐born women. Intervention rates increased from the earlier to the later time period by 13.1% across the study population, but the increase was larger in African and South Asian‐born women (18.1% and 19.6% respectively) than AUS/NZ‐born women (11.2%). There was a significant interaction between ethnicity and time period for South Asian‐born women in the all‐births model, with their stillbirth rates becoming closer to AUS/NZ‐born women in the later period. Conclusion South Asian, African and Oceanian maternal region of birth are independent risk factors for stillbirth in NSW.
AbstractList	Background Research suggests that in Australia, maternal region of birth is a risk factor for stillbirth. Aims We aimed to examine the relationship between stillbirth and maternal region of birth in New South Wales (NSW), Australia from 2004 to 2015. Methods Adjusted logistic regression was used to determine odds of stillbirth by maternal region of birth, compared with Australian or New Zealand‐born (AUS/NZ‐born) women. Intervention rates (induction or pre‐labour caesarean) by maternal region of birth, over time, were also examined. Interaction terms were used to assess change in relative odds of stillbirth, over two time periods (2004–2011 and 2012–2015). Results There were 944 457 singleton births ≥24 weeks gestation that met the study inclusion criteria and 3221 of these were stillbirths, giving a stillbirth rate of 3.4 per 1000 births. After adjustment for confounders, South Asian (adjusted odds ratio (aOR) 1.42, 95% CI 1.24–1.62), Oceanian (aOR 1.45, 95% CI 1.17–1.80) and African (aOR 1.46, 96% CI 1.19–1.80) born women had significantly higher odds of stillbirth that AUS/NZ‐born women. Intervention rates increased from the earlier to the later time period by 13.1% across the study population, but the increase was larger in African and South Asian‐born women (18.1% and 19.6% respectively) than AUS/NZ‐born women (11.2%). There was a significant interaction between ethnicity and time period for South Asian‐born women in the all‐births model, with their stillbirth rates becoming closer to AUS/NZ‐born women in the later period. Conclusion South Asian, African and Oceanian maternal region of birth are independent risk factors for stillbirth in NSW. Research suggests that in Australia, maternal region of birth is a risk factor for stillbirth.BACKGROUNDResearch suggests that in Australia, maternal region of birth is a risk factor for stillbirth.We aimed to examine the relationship between stillbirth and maternal region of birth in New South Wales (NSW), Australia from 2004 to 2015.AIMSWe aimed to examine the relationship between stillbirth and maternal region of birth in New South Wales (NSW), Australia from 2004 to 2015.Adjusted logistic regression was used to determine odds of stillbirth by maternal region of birth, compared with Australian or New Zealand-born (AUS/NZ-born) women. Intervention rates (induction or pre-labour caesarean) by maternal region of birth, over time, were also examined. Interaction terms were used to assess change in relative odds of stillbirth, over two time periods (2004-2011 and 2012-2015).METHODSAdjusted logistic regression was used to determine odds of stillbirth by maternal region of birth, compared with Australian or New Zealand-born (AUS/NZ-born) women. Intervention rates (induction or pre-labour caesarean) by maternal region of birth, over time, were also examined. Interaction terms were used to assess change in relative odds of stillbirth, over two time periods (2004-2011 and 2012-2015).There were 944 457 singleton births ≥24 weeks gestation that met the study inclusion criteria and 3221 of these were stillbirths, giving a stillbirth rate of 3.4 per 1000 births. After adjustment for confounders, South Asian (adjusted odds ratio (aOR) 1.42, 95% CI 1.24-1.62), Oceanian (aOR 1.45, 95% CI 1.17-1.80) and African (aOR 1.46, 96% CI 1.19-1.80) born women had significantly higher odds of stillbirth that AUS/NZ-born women. Intervention rates increased from the earlier to the later time period by 13.1% across the study population, but the increase was larger in African and South Asian-born women (18.1% and 19.6% respectively) than AUS/NZ-born women (11.2%). There was a significant interaction between ethnicity and time period for South Asian-born women in the all-births model, with their stillbirth rates becoming closer to AUS/NZ-born women in the later period.RESULTSThere were 944 457 singleton births ≥24 weeks gestation that met the study inclusion criteria and 3221 of these were stillbirths, giving a stillbirth rate of 3.4 per 1000 births. After adjustment for confounders, South Asian (adjusted odds ratio (aOR) 1.42, 95% CI 1.24-1.62), Oceanian (aOR 1.45, 95% CI 1.17-1.80) and African (aOR 1.46, 96% CI 1.19-1.80) born women had significantly higher odds of stillbirth that AUS/NZ-born women. Intervention rates increased from the earlier to the later time period by 13.1% across the study population, but the increase was larger in African and South Asian-born women (18.1% and 19.6% respectively) than AUS/NZ-born women (11.2%). There was a significant interaction between ethnicity and time period for South Asian-born women in the all-births model, with their stillbirth rates becoming closer to AUS/NZ-born women in the later period.South Asian, African and Oceanian maternal region of birth are independent risk factors for stillbirth in NSW.CONCLUSIONSouth Asian, African and Oceanian maternal region of birth are independent risk factors for stillbirth in NSW. Research suggests that in Australia, maternal region of birth is a risk factor for stillbirth. We aimed to examine the relationship between stillbirth and maternal region of birth in New South Wales (NSW), Australia from 2004 to 2015. Adjusted logistic regression was used to determine odds of stillbirth by maternal region of birth, compared with Australian or New Zealand-born (AUS/NZ-born) women. Intervention rates (induction or pre-labour caesarean) by maternal region of birth, over time, were also examined. Interaction terms were used to assess change in relative odds of stillbirth, over two time periods (2004-2011 and 2012-2015). There were 944 457 singleton births ≥24 weeks gestation that met the study inclusion criteria and 3221 of these were stillbirths, giving a stillbirth rate of 3.4 per 1000 births. After adjustment for confounders, South Asian (adjusted odds ratio (aOR) 1.42, 95% CI 1.24-1.62), Oceanian (aOR 1.45, 95% CI 1.17-1.80) and African (aOR 1.46, 96% CI 1.19-1.80) born women had significantly higher odds of stillbirth that AUS/NZ-born women. Intervention rates increased from the earlier to the later time period by 13.1% across the study population, but the increase was larger in African and South Asian-born women (18.1% and 19.6% respectively) than AUS/NZ-born women (11.2%). There was a significant interaction between ethnicity and time period for South Asian-born women in the all-births model, with their stillbirth rates becoming closer to AUS/NZ-born women in the later period. South Asian, African and Oceanian maternal region of birth are independent risk factors for stillbirth in NSW.
Author	Davies‐Tuck, Miranda L. Torvaldsen, Siranda Ibiebele, Ibinabo Ford, Jane B. Randall, Deborah Nippita, Tanya Berman, Ye’elah Morris, Jonathan M. Patterson, Jillian A.
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Snippet	Background Research suggests that in Australia, maternal region of birth is a risk factor for stillbirth. Aims We aimed to examine the relationship between... Research suggests that in Australia, maternal region of birth is a risk factor for stillbirth. We aimed to examine the relationship between stillbirth and... Research suggests that in Australia, maternal region of birth is a risk factor for stillbirth.BACKGROUNDResearch suggests that in Australia, maternal region of...
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SubjectTerms	Adult Africa - epidemiology Asia - epidemiology Asian People - statistics & numerical data birth intervention Black People - statistics & numerical data ethnicity Ethnicity - statistics & numerical data Female Gestational Age Humans Logistic Models maternal region of birth New South Wales - epidemiology New Zealand - epidemiology Odds Ratio Pregnancy Risk Factors stillbirth Stillbirth - epidemiology Young Adult
Title	Rates of stillbirth by maternal region of birth and gestational age in New South Wales, Australia 2004–2015
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