Healthcare factors associated with the risk of antepartum and intrapartum stillbirth in migrants in western Australia (2005-2013): A retrospective cohort study
PLoS Medicine Mar 22, 2020
Mozooni M, et al. - In view of unacceptably high rate of stillbirth (SB) high among ethnic groups and migrant populations living in high-income countries despite the availability of advanced pregnancy and childbirth care, researchers here investigated migrant women in Western Australia (WA) for their pattern of healthcare utilisation and its correlation with the risk of SB—antepartum stillbirth (AnteSB) and intrapartum stillbirth (IntraSB). They used routinely collected administrative health and registry data to examine all births to the non-Indigenous population of WA from 2005 to 2013, including 260,997 live births and SBs. Increased risk of SB was observed in specific ethnic groups of migrants in correlation with following factors: late commencement of ANC, not utilised interpreter services, lack of private health insurance, and midwife-only care during birth. African, Indian, and other women had elevated odds of AnteSB whereas African and ‘other’ women had higher IntraSB compared with Australian-born women. Reduction in the risk of SB may be achieved with engaging women with ANC early in pregnancy, offering interpreter service proactively, providing more frequent ultrasound surveillance, and involving a team (both doctor and midwife) for care during birth for specific at-risk groups.
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