title: Bibbulung Gnarneep ('solid kid'): causal pathways to poor birth outcomes in an urban Aboriginal birth cohort.
abstract: OBJECTIVE
  To explore the causal pathways leading to poor birth outcomes among a cohort of Aboriginal infants.
  
  
  METHODS
  A cross-sectional study was conducted. Data were collected via face-to-face interviews conducted 6-12 weeks post partum and links to the WA Midwives' Notification System. Two hundred and seventy-three Aboriginal infants and their families from Perth, Western Australia were recruited in the mid to late 1990s.
  
  
  RESULTS
  Poor birth outcome was defined as low birth weight and/or preterm birth. Criteria for poor birth outcome were met by 12.3% of the cohort. A history of maternal hypertension, vaginal bleeding and consumption of excess spirits in pregnancy were independent predictors of poor birth outcome. Mother being raised on a mission, maternal education, smoking during pregnancy and being exposed to passive smoke during pregnancy were also important risk factors.
  
  
  CONCLUSIONS
  Results indicate that maternal social exposures, maternal ill-health before the index pregnancy and maternal ill-health during the index pregnancy are all important contributors to poor birth outcomes for urban Aboriginal infants. While the causes of poor birth outcomes are complex, the current study highlights several areas where preventive measures may be useful.
authors.affiliation: The Sax Institute, Broadway, New South Wales, Australia. sandra.eades@saxinstitute.org.au
authors.forename: Sandra
authors.initials: S
authors.lastname: Eades
authors.forename: Anne W
authors.initials: AW
authors.lastname: Read
authors.forename: Fiona J
authors.initials: FJ
authors.lastname: Stanley
authors.forename: Francine N
authors.initials: FN
authors.lastname: Eades
authors.forename: Daniel
authors.initials: D
authors.lastname: McCaullay
authors.forename: Anna
authors.initials: A
authors.lastname: Williamson
mesh_terms: D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007407:Interviews as Topic; D008429:Maternal Welfare; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000208:ethnology; D011256:Pregnancy Outcome / Q000208:ethnology*; D012907:Smoking / Q000208:ethnology; D012959:Socioeconomic Factors; D014904:Western Australia / Q000453:epidemiology