title: Preterm birth in the Inuit and First Nations populations of Québec, Canada, 1981-2008.
abstract: OBJECTIVE
  To evaluate preterm birth (PTB) for Inuit and First Nations vs. non-Indigenous populations in the province of Québec, Canada.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  We evaluated singleton live births for Québec residents, 1981-2008 (n = 2,310,466). Municipality of residence (Inuit-inhabited, First Nations-inhabited, rest of Québec) and language (Inuit, First Nations, French/English) were used to identify Inuit and First Nations births. The outcome was PTB (<37 completed weeks). Cox proportional hazards regression was employed to estimate hazard ratios (HR) and 95% confidence intervals (CI) of PTB, adjusting for maternal age, education, marital status, parity and birth year.
  
  
  RESULTS
  PTB rates were higher for Inuit language speakers in Inuit-inhabited areas and the rest of Québec compared with French/English speakers in the rest of Québec, and disparities persisted over time. Relative to French/English speakers in the rest of Québec, Inuit language speakers in the rest of Québec had the highest risk of PTB (HR 1.98, 95% CI: 1.62-2.41). The risk was also elevated for Inuit language speakers in Inuit-inhabited areas, though to a lesser extent (HR 1.29, 95% CI: 1.18-1.41). In contrast, First Nations language speakers in First Nations-inhabited areas and the rest of Québec had similar or lower risks of PTB relative to French/English speakers in the rest of Québec.
  
  
  CONCLUSIONS
  Inuit populations, especially those outside Inuit-inhabited areas, have persistently elevated risks of PTB, indicating a need for strategies to prevent PTB in this population.
authors.affiliation: Institut national de santé publique du Québec, Montréal, Québec H2P 1E2, Canada. nathalie.auger@inspq.qc.ca
authors.forename: Nathalie
authors.initials: N
authors.lastname: Auger
authors.forename: Mélanie
authors.initials: M
authors.lastname: Fon Sing
authors.forename: Alison L
authors.initials: AL
authors.lastname: Park
authors.forename: Ernest
authors.initials: E
authors.lastname: Lo
authors.forename: Normand
authors.initials: N
authors.lastname: Trempe
authors.forename: Zhong-Cheng
authors.initials: ZC
authors.lastname: Luo
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007198:Indians, North American; D007231:Infant, Newborn; D004930:Inuit; D047928:Premature Birth / Q000453:epidemiology*; D011792:Quebec; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult