title: Macrosomia, Perinatal and Infant Mortality in Cree Communities in Quebec, 1996-2010.
abstract: BACKGROUND
  Cree births in Quebec are characterized by the highest reported prevalence of macrosomia (~35%) in the world. It is unclear whether Cree births are at greater elevated risk of perinatal and infant mortality than other First Nations relative to non-Aboriginal births in Quebec, and if macrosomia may be related.
  
  
  METHODS
  This was a population-based retrospective birth cohort study using the linked birth-infant death database for singleton births to mothers from Cree (n = 5,340), other First Nations (n = 10,810) and non-Aboriginal (n = 229,960) communities in Quebec, 1996-2010. Community type was ascertained by residential postal code and municipality name. The primary outcomes were perinatal and infant mortality.
  
  
  RESULTS
  Macrosomia (birth weight for gestational age >90th percentile) was substantially more frequent in Cree (38.0%) and other First Nations (21.9%) vs non-Aboriginal (9.4%) communities. Comparing Cree and other First Nations vs non-Aboriginal communities, perinatal mortality rates were 1.52 (95% confidence intervals 1.17, 1.98) and 1.34 (1.10, 1.64) times higher, and infant mortality rates 2.27 (1.71, 3.02) and 1.49 (1.16, 1.91) times higher, respectively. The risk elevations in perinatal and infant death in Cree communities attenuated after adjusting for maternal characteristics (age, education, marital status, parity), but became greater after further adjustment for birth weight (small, appropriate, or large for gestational age).
  
  
  CONCLUSIONS
  Cree communities had greater risk elevations in perinatal and infant mortality than other First Nations relative to non-Aboriginal communities in Quebec. High prevalence of macrosomia did not explain the elevated risk of perinatal and infant mortality in Cree communities.
authors: Public Health Department, Cree Board of Health and Social Services of James Bay, Mistissini, Quebec, G0W 1C0, Canada.|Department of Obstetrics and Gynecology, Sainte-Justine Hospital, University of Montreal, Montreal, Quebec, H3T 1C5, Canada.
authors: Lin
authors: L
authors: Xiao
authors: Department of Obstetrics and Gynecology, Sainte-Justine Hospital, University of Montreal, Montreal, Quebec, H3T 1C5, Canada.|Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, 200092, China.
authors: Dan-Li
authors: DL
authors: Zhang
authors: Public Health Department, Cree Board of Health and Social Services of James Bay, Mistissini, Quebec, G0W 1C0, Canada.
authors: Jill
authors: J
authors: Torrie
authors: University of Montreal Hospital Research Centre, University of Montreal, Montreal, Quebec, H2X 0A9, Canada.
authors: Nathalie
authors: N
authors: Auger
authors: Research Division, First Nations of Quebec and Labrador Health and Social Service Commission, Wendake, Quebec, G0A 4V0, Canada.
authors: Nancy Gros-Louis
authors: NG
authors: McHugh
authors: Department of Obstetrics and Gynecology, Sainte-Justine Hospital, University of Montreal, Montreal, Quebec, H3T 1C5, Canada.|Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, 200092, China.
authors: Zhong-Cheng
authors: ZC
authors: Luo
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005320:Fetal Macrosomia / Q000208:ethnology* / Q000401:mortality*; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000208:ethnology*; D008297:Male; D011792:Quebec / Q000453:epidemiology / Q000208:ethnology; D012189:Retrospective Studies; D055815:Young Adult