Reducing preterm birth amongst Aboriginal and Torres Strait Islander babies: A prospective cohort study, Brisbane, Australia.
EClinicalMedicine
; 12: 43-51, 2019 Jul.
Article
em En
| MEDLINE
| ID: mdl-31388662
ABSTRACT
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 (nâ¯=â¯461) to women receiving standard care (nâ¯=â¯563), January 2013-December 2017. The primary outcome was preterm birth (< 37â¯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, nâ¯=â¯1024 ORâ¯=â¯0·57, 95% CI 0·37, 0·89; matched, nâ¯=â¯690 ORâ¯=â¯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.
Aboriginal Community Controlled Health Organisations; Aboriginal and Torres Strait Islander; Birth cohort; Birthing in Our Community; Birthing on Country; Child mortality; Closing the gap; Co-design; Community; Community investment-ownership-activation; Continuity of midwifery care; Health disparities; Health services research; Indigenous; Maternity; Midwifery; Preterm birth; Propensity score matching; Prospective study; The Indigenous Birthing in an Urban Setting (IBUS) study
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Etiology_studies
/
Observational_studies
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article