title: Risk factors for preterm, low birthweight and small for gestational age births among Aboriginal women from remote communities in Northern Australia.
abstract: OBJECTIVE
  To identify the risk factors for preterm birth, low birthweight and small for gestational age babies among remote-dwelling Aboriginal women.
  
  
  METHODS
  The study included 713 singleton births from two large remote Aboriginal communities in Northern Territory, Australia in 2004-2006 (retrospective cohort) and 2009-2011 (prospective cohort). Demographic, pregnancy characteristics, labour and birth outcomes were described. Multivariate logistic regression analysis was conducted and adjusted odds ratios were reported.
  
  
  RESULTS
  The preterm birth rate was 19.4%, low birthweight rate was 17.4% and small for gestational age rate was 16.3%. Risk factors for preterm birth were teenage motherhood, previous preterm birth, smoker status not recorded, inadequate antenatal visits, having pregnancy-induced hypertension, antepartum haemorrhage or placental complications. After adjusting for gender and birth gestation, the only significant risk factor for low birthweight was first time mother. The only significant risk factor for small for gestational age baby was women having their first baby.
  
  
  CONCLUSIONS
  Rates of these events are high and have changed little over time. Some risk factors are modifiable and treatable but need early, high quality, culturally responsive women centred care delivered in the remote communities themselves. A different approach is recommended.
authors.affiliation: School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Qld 4010, Australia; Mater Research Institute - The University of Queensland, Brisbane, Qld 4101, Australia. Electronic address: sue.kildea@mater.uq.edu.au.
authors.forename: Sue V
authors.initials: SV
authors.lastname: Kildea
authors.affiliation: School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Qld 4010, Australia; Mater Research Institute - The University of Queensland, Brisbane, Qld 4101, Australia.
authors.forename: Yu
authors.initials: Y
authors.lastname: Gao
authors.affiliation: University Centre for Rural Health North Coast, Sydney Medical School, University of Sydney, Lismore, NSW 2480, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Rolfe
authors.affiliation: Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Boyle
authors.affiliation: School of Nursing, University of Sydney, Sydney, NSW 2050, Australia.
authors.forename: Sally
authors.initials: S
authors.lastname: Tracy
authors.affiliation: University Centre for Rural Health North Coast, Sydney Medical School, University of Sydney, Lismore, NSW 2480, Australia.
authors.forename: Lesley M
authors.initials: LM
authors.lastname: Barclay
mesh_terms: D000328:Adult; D017677:Age Distribution; D015984:Causality; D005260:Female; D005865:Gestational Age; D006304:Health Status; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D015876:Northern Territory / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011295:Prenatal Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*
keywords: Indigenous Australian; Low birthweight; Preterm birth; Remote; Small for gestational age