Abstracts of theses and treatises
Murphy K (nd) Socio-economic factors and perinatal mortality in Queensland 1987-1988. Unpublished Master of Public Health thesis, University of Queensland, Brisbane, Queensland.
Objective: To assess the effects of perinatal mortality of socio-economic status; ethnicity and place of residence.
Design: An analysis of data from the first two years (1987-1988) of the Queensland Perinatal Data Collection. Birthweight specific and gestational age specific mortality rates were calculated by ethnic group. Mortality rates and rate ratios were calculated for ethnicity, non English speaking background, socio-economic status, patient class, marital status, number of antenatal visits and place of residence. Maps were produced of mortality rates for each Statistical Local Area.
Subjects: All births and perinatal deaths in Queensland for the years 1987 and 1988. There were 80,409 births and 1016 perinatal deaths, comprising 876 stillbriths and 581 neonatal deaths.
Main outcome measures: Perinatal mortality rates, stillbirth rates, neonatal mortality rates.
Results: Aboriginals (26.0/1,000 births) and Torres Strait Islanders (28.7/1,000 births) had higher perinatal mortality rates than Whites (11.9/1,000 births) and Asians (9.7/1,000 births). The risk ratio for perinatal mortality for Aboriginals compared with Whites was 2.21 (95%CI 1.71, 2.86) and 2.45 (95%CI 1.61, 3.69) for Torres Strait Islanders. There was no significant difference between Asians and Whites. When adjusted for low birth weight, there was no significant difference between Whites and Aboriginals and Whites and Torres Strait Islanders.
There was no significant difference in mortality between babies of mothers born in non English speaking countries and those born in English speaking countries.
Socio-economic status was inversely proportional to mortality. The perinatal mortality rate for the highest socio-economic quintile was 10.3/1,000 births compared with the rate for the lowest quintile of 15.3/1,000 births. The rate ratio for perinatal mortality compared the highest and lowest quintiles of socio-economic status was 1.50 (95%CI 1.19, 1.88).
There was no significant difference in the mortality rates between Statistical Divisions.
Analysing smaller geographical areas, Statistical Local Areas, higher mortality rates occurred in areas that were isolated, had a high Aboriginal population and were low socio-economic areas.
The number of antenatal visits was inversely proportional to mortality. The crude rate ratio comparing no or one antenatal visit with seven or more visits being 9.37 (95%CI 7.82, 11.22) for perinatal mortality.
It should be noted that a number of the above variables are co-related and the above findings for individual variables may not be independent.
Following multivariate analysis, the rate ratios for variables associated with increased perinatal mortality that were significant were: socio-economic status 2.28 (95%CI 1.99, 2.60); very low birth weight (<1,500 grams) 3.30 (95%CI 2.85, 3.82); low birth weight (<2.500 grams) 2.30 (95%CI 2.04, 2.59); permaturity (<36 weeks) 2.08 (95%CI 1.77, 2.45); public patent class 2.19 (95%CI 1,96, 2.46); and marital status 2.27 (95%CI 2.01, 2.56).
Conclusions: Factors significantly associated with perinatal mortality were low birth weight, prematurity, socio-economic status and marital status.
Factors significantly associated with stillbirth were low birth weight, prematurity, high birth weight (>4,500 grams), socio-economic status, marital status, low number of antenatal visits, multiple births, maternal age over 40 and having a male baby.
Factors significantly associated with neonatal mortality were low birthweight, prematurity, socio-economic status, marital status and patient class.
For further information on this subject look in the Australian Indigenous HealthInfoNet Bibliography or return to the theses page.
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