Abstract：
OBJECTIVE: To examine low birth weight (LBW) in First Nations babies born in a large metropolitan health service in Queensland, Australia.
METHODS: A retrospective population-based study using routinely collected data from administrative data sources. All singleton births in metropolitan health services, Queensland, Australia of ≥20 weeks gestation or at least 400 g birthweight and had information on First Nations status and born between 2019 and 2021 were included. The study measured birthweight and birthweight z-score, and also identified the predictors of LBW. Multivariate regression models were adjusted by demographic, socioeconomic and perinatal factors.
RESULTS: First Nations babies had higher rates of LBW (11.4% vs 6.9%, P < 0.001), with higher rates of preterm birth (13.9% vs 8.8%, P < 0.001). In all babies, the most important factors contributing to LBW were: maternal smoking after 20 weeks of gestation; maternal pre-pregnancy underweight (body mass index <18.5 kg/m2); nulliparity; socioeconomic disadvantage; geographical remoteness; less frequent antenatal care; history of cannabis use; pre-existing cardiovascular disease; pre-eclampsia; antepartum haemorrhage; and birth outcomes including prematurity and female baby. After adjusting for all contributing factors, no difference in odds of LBW was observed between First Nations and non-First Nation babies.
CONCLUSIONS: First Nations status was not an independent factor influencing LBW in this cohort, after adjustment for identifiable factors. The disparity in LBW relates to modifiable risk factors, socioeconomic disadvantage, and prematurity. Upscaling culturally safe maternity care, focusing on modifiable risk factors is required to address LBW in Australian women.
METHODS: A retrospective population-based study using routinely collected data from administrative data sources. All singleton births in metropolitan health services, Queensland, Australia of ≥20 weeks gestation or at least 400 g birthweight and had information on First Nations status and born between 2019 and 2021 were included. The study measured birthweight and birthweight z-score, and also identified the predictors of LBW. Multivariate regression models were adjusted by demographic, socioeconomic and perinatal factors.
RESULTS: First Nations babies had higher rates of LBW (11.4% vs 6.9%, P < 0.001), with higher rates of preterm birth (13.9% vs 8.8%, P < 0.001). In all babies, the most important factors contributing to LBW were: maternal smoking after 20 weeks of gestation; maternal pre-pregnancy underweight (body mass index <18.5 kg/m2); nulliparity; socioeconomic disadvantage; geographical remoteness; less frequent antenatal care; history of cannabis use; pre-existing cardiovascular disease; pre-eclampsia; antepartum haemorrhage; and birth outcomes including prematurity and female baby. After adjusting for all contributing factors, no difference in odds of LBW was observed between First Nations and non-First Nation babies.
CONCLUSIONS: First Nations status was not an independent factor influencing LBW in this cohort, after adjustment for identifiable factors. The disparity in LBW relates to modifiable risk factors, socioeconomic disadvantage, and prematurity. Upscaling culturally safe maternity care, focusing on modifiable risk factors is required to address LBW in Australian women.
摘要：
目的：检查昆士兰州大城市卫生服务机构出生的原住民婴儿的低出生体重（LBW），澳大利亚。
方法：一项基于人群的回顾性研究，使用从管理数据源中常规收集的数据。大都市医疗服务中的所有单胎出生，昆士兰，包括妊娠≥20周或至少400克出生体重的澳大利亚，并有关于第一民族身份的信息，出生在2019年至2021年之间。这项研究测量了出生体重和出生体重z评分，并确定了LBW的预测因子。多元回归模型按人口统计校正，社会经济和围产期因素。
结果：第一民族婴儿的低出生体重率较高（11.4%vs6.9%，P<0.001)，早产率较高(13.9%vs8.8%，P<0.001)。在所有婴儿中，导致LBW的最重要因素是:妊娠20周后孕妇吸烟;孕妇孕前体重过轻(体重指数<18.5kg/m2);无效;社会经济劣势;地理偏远;产前护理频率较低;大麻使用史;既往心血管疾病;先兆子痫;产前出血;分娩结局包括早产和女婴.在对所有影响因素进行调整后，原住民和非原住民婴儿的LBW几率没有差异.
结论：第一民族状态不是影响该队列LBW的独立因素，在对可识别的因素进行调整后。LBW的差异与可改变的风险因素有关，社会经济劣势，和早熟。扩大文化安全的产妇保健，解决澳大利亚女性的LBW问题需要关注可改变的风险因素.
方法：一项基于人群的回顾性研究，使用从管理数据源中常规收集的数据。大都市医疗服务中的所有单胎出生，昆士兰，包括妊娠≥20周或至少400克出生体重的澳大利亚，并有关于第一民族身份的信息，出生在2019年至2021年之间。这项研究测量了出生体重和出生体重z评分，并确定了LBW的预测因子。多元回归模型按人口统计校正，社会经济和围产期因素。
结果：第一民族婴儿的低出生体重率较高（11.4%vs6.9%，P<0.001)，早产率较高(13.9%vs8.8%，P<0.001)。在所有婴儿中，导致LBW的最重要因素是:妊娠20周后孕妇吸烟;孕妇孕前体重过轻(体重指数<18.5kg/m2);无效;社会经济劣势;地理偏远;产前护理频率较低;大麻使用史;既往心血管疾病;先兆子痫;产前出血;分娩结局包括早产和女婴.在对所有影响因素进行调整后，原住民和非原住民婴儿的LBW几率没有差异.
结论：第一民族状态不是影响该队列LBW的独立因素，在对可识别的因素进行调整后。LBW的差异与可改变的风险因素有关，社会经济劣势，和早熟。扩大文化安全的产妇保健，解决澳大利亚女性的LBW问题需要关注可改变的风险因素.
