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

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2019
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Abstract
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'.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.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).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.
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kildea2019reducingeclinicalmedicine Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Kildea, Sue;Gao, Yu;Hickey, Sophie;Kruske, Sue;Nelson, Carmel;Blackman, Renee;Tracy, Sally;Hurst, Cameron;Williamson, Daniel;Roe, Yvette;
Journal eclinicalmedicine
Year 2019
DOI
10.1016/j.eclinm.2019.06.001
URL
Keywords
health disparities propensity score matching indigenous community health services research midwifery prospective study child mortality preterm birth aboriginal and torres strait islander aboriginal community controlled health organisations birth cohort birthing in our community birthing on country closing the gap co-design community investment-ownership-activation continuity of midwifery care maternity the indigenous birthing in an urban setting (ibus) study

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