Maternal region of birth and stillbirth in Victoria, Australia 2000–2011: A retrospective cohort study of Victorian perinatal data

There is growing evidence from high-income countries that maternal country of birth is a risk factor for stillbirth. We aimed to examine the association between maternal region of birth and stillbirth between 2000 and 2011 inclusive in Victoria, Australia. Retrospective population based cohort study...

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Vydáno v:	PloS one Ročník 12; číslo 6; s. e0178727
Hlavní autoři:	Davies-Tuck, Miranda L., Davey, Mary-Ann, Wallace, Euan M.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Public Library of Science 06.06.2017 Public Library of Science (PLoS)
Témata:	Aboriginal Australians Accuracy Adult Age Anomalies Asia - epidemiology Australia - epidemiology Babies Birth Births Childbirth & labor Cohort analysis Congenital Abnormalities - epidemiology Congenital Abnormalities - physiopathology Congenital anomalies Congenital defects Country of birth Data collection Ethnicity Far East - epidemiology Female Gestation Gestational Age Gynecology Health aspects Health risk assessment Hemorrhage Humans Hypertension Income Maternal Age Medical research Medicine and Health Sciences Minority & ethnic groups Obstetrics People and Places Placenta Population Population studies Pregnancy Pregnancy Complications - epidemiology Pregnancy Complications - physiopathology Premature Birth - epidemiology Premature Birth - physiopathology Prenatal care Risk analysis Risk Factors Socioeconomics Stillbirth Stillbirth - epidemiology Studies Ultrasound Variables Womens health Australia United Kingdom > UK Victoria Australia
ISSN:	1932-6203, 1932-6203
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Shrnutí:	There is growing evidence from high-income countries that maternal country of birth is a risk factor for stillbirth. We aimed to examine the association between maternal region of birth and stillbirth between 2000 and 2011 inclusive in Victoria, Australia. Retrospective population based cohort study of all singleton births at 24 or more weeks gestational age from 2000-2011 in Victoria, Australia. Stillbirths due to termination of pregnancy, babies with congenital anomalies and Indigenous mothers were excluded. Main Outcome Measure: Stillbirth. Over the 12-year period there were 685,869 singleton births and 2299 stillbirths, giving an overall stillbirth rate of 3·4 per 1000 births. After adjustment for risk factors, compared to women born in Australia/New Zealand, women born in South Asia (aOR 1.27, 95% CI 1.01-1.53, p = 0.01), were more likely to have a stillbirth whereas women born in South East and East Asia were (aOR 0.60, (95% CI 0.49-0.72, p<0.001) less likely to have a stillbirth. Additionally, the increasing rate of stillbirth as gestation length progressed began to rise earlier and more steeply in the South Asian compared to Australian/New Zealand born women. The following risk factors were also significantly associated with an increased odds of stillbirth in multivariate analyses: maternal age <20 and 35 years and more, nulliparity, low socio-economic status, previous stillbirth, no ultrasound reported in 1st trimester, pre-existing hypertension, antepartum haemorrhage and failure to detect growth restriction antenatally. Maternal region of birth is an independent risk factor for stillbirth. Improvements in the rate of stillbirth, particularly late pregnancy stillbirth, are likely to be gained in high-income settings where clinical care is informed by maternal region of birth.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: MDT has a secondment 1 day per week to CCOPMM. MAD is a part time employee of Clinical Councils Unit which manages the VPDC data and EW is a CEO of Safer Care Victoria, Department of health. These conflicts do not alter adherence to the PLOS ONE policies. Conceptualization: MDT MAD EW.Data curation: MDT MAD EW.Formal analysis: MDT MAD.Funding acquisition: MDT.Investigation: MDT MAD.Methodology: MDT MAD EW.Project administration: MDT MAD EW.Resources: EW.Supervision: EW.Validation: MDT MAD EW.Visualization: MDT MAD EW.Writing – original draft: MDT MAD EW.Writing – review & editing: MDT MAD EW.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0178727