Health outcomes for Australian Aboriginal and Torres Strait Islander children born preterm, low birthweight or small for gestational age: A nationwide cohort study
journal contributionposted on 16.06.2021, 02:24 by Elizabeth Westrupp, Fabrizio D'Esposito, Jane Freemantle, Fiona K Mensah, Jan Nicholson
Objective To examine health outcomes in Australian Aboriginal and Torres Strait Islander children experiencing perinatal risk and identify protective factors in the antenatal period. Methods Baby/Child cohorts of the Longitudinal Study of Indigenous Children, born 2001–2008, across four annual surveys (aged 0–8 years, N = 1483). Children with ‘mild’ and ‘moderate-to-high’ perinatal risk were compared to children born normal weight at term for maternal-rated global health and disability, and body-mass-index measured by the interviewer. Results Almost one third of children had experienced mild (22%) or moderate-to-high perinatal risk (8%). Perinatal risk was associated with lower body-mass-index z-scores (regression coefficients adjusted for pregnancy and environment factors: mild = -0.21, 95% CI = -0.34, -0.07; moderate-to-high = -0.42, 95% CI = -0.63, -0.21). Moderate-to-high perinatal risk was associated with poorer global health, with associations becoming less evident in models adjusted for pregnancy and environment factors; but not evident for disability. A range of protective factors, including cultural-based resilience and smoking cessation, were associated with lower risk of adverse outcomes. Conclusions Perinatal risks are associated with Australian Aboriginal and Torres Strait children experiencing adverse health particularly lower body weight. Cultural-based resilience and smoking cessation may be two modifiable pathways to ameliorating health problems associated with perinatal risk.
EMW was supported by the Centre of Research Excellence in Child Language (Australian National Health and Medical Research Council NHMRC grant 1023493). EMW and JN were supported by the Australian Communities Foundation through the Roberta Holmes Transition to Contemporary Parenthood Program (Coronella sub-fund). FM was supported by an NHMRC Early Career Fellowship 1037449 and Career Development Fellowship 1111160. JF was supported by an ARC Australian Research Fellowship DP0880637. Research at MCRI is supported by the Victorian Government's Operational Infrastructure Support Program. Authors have no other relevant disclosures. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This paper uses unit record data from Footprints in Time, the Longitudinal Study of Indigenous Children. The study is conducted and managed by the Australian Government Department of Social Services (DSS, formerly the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs).
PublisherPublic Library of Science (PLoS)
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Science & TechnologyMultidisciplinary SciencesScience & Technology - Other TopicsALCOHOLPROGRESSDISEASEWOMENRISKSIZECAREHumansPremature BirthBody Mass IndexHealth SurveysRiskCohort StudiesLongitudinal StudiesChildChild, PreschoolInfantInfant, NewbornInfant, Low Birth WeightInfant, Small for Gestational AgeOceanic Ancestry GroupHealth Services, IndigenousHealth Services AccessibilityAustraliaFemaleMaleGeneral Science & Technology