Rates of neonatal morbidity by maternal region of birth and gestational age in New South Wales, Australia 2003‐2016

2020 ◽  
Author(s):  
Ye’elah Berman ◽  
Ibinabo Ibiebele ◽  
Deborah Randall ◽  
Siranda Torvaldsen ◽  
Tanya A. Nippita ◽  
...  
Keyword(s):  
Gestational Age ◽  
New South ◽  
New South Wales ◽  
Neonatal Morbidity ◽  
South Wales

scholarly journals Are newly introduced criteria for the diagnosis of gestational diabetes mellitus associated with improved pregnancy outcomes and/or increased interventions in New South Wales, Australia? A population-based data linkage study

2021 ◽  
Vol 9 (1) ◽  
pp. e002277
Author(s):  
Deborah A Randall ◽  
Jonathan M Morris ◽  
Patrick Kelly ◽  
Sarah J Glastras
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
New South ◽  
New South Wales ◽  
Neonatal Morbidity ◽  
Adverse Outcomes ◽  
Newly Diagnosed ◽  
South Wales

IntroductionThe incidence of gestational diabetes mellitus (GDM) is increasing in Australia, influenced by changed diagnostic criteria. We aimed to identify whether the diagnostic change was associated with improved outcomes and/or increased obstetric interventions using state-wide data in New South Wales (NSW), Australia.Research design and methodsPerinatal and hospital data were linked for singleton births, 33–41 weeks’ gestation, 2006–2015, NSW. An adjusted Poisson model was used to split pregnancies from 2011 onwards into those that would have been diagnosed under the old criteria (‘previous GDM’) and newly diagnosed cases (‘additional GDM’). We compared actual rates of total and early (<39 weeks) planned births, cesareans, and maternal and neonatal adverse outcomes for GDM-diagnosed pregnancies using three predicted scenarios, where the ‘additional GDM’ group was assumed to have the same rates as: the ‘previous GDM’ group <2011 (scenario A); the ‘non-GDM’ group <2011 (scenario B); or the ‘non-GDM’ group ≥2011 (scenario C).ResultsGDM incidence more than doubled over the study period, with an inflection point observed at 2011. For those diagnosed with GDM since 2011, the actual incidence of interventions (planned births and cesareans) and macrosomia was consistent with scenario A, which meant higher intervention rates, but lower rates of macrosomia, than those with no GDM. Incidence of neonatal hypoglycemia was lower than scenario A and closer to the other scenarios. There was a reduction in perinatal deaths among those with GDM, lower than that predicted by all scenarios, indicating an improvement for all with GDM, not only women newly diagnosed. Incidence of maternal and neonatal morbidity indicators was within the confidence bounds for all three predicted scenarios.ConclusionsOur study suggests that the widely adopted new diagnostic criteria for GDM are associated with increased obstetric intervention rates and lower rates of macrosomic babies, but with no clear impacts on maternal or neonatal morbidity.

Rates of stillbirth by maternal region of birth and gestational age in New South Wales, Australia 2004–2015

2019 ◽  
Vol 60 (3) ◽  
pp. 425-432
Author(s):  
Ye’elah Berman ◽  
Ibinabo Ibiebele ◽  
Jillian A. Patterson ◽  
Deborah Randall ◽  
Jane B. Ford ◽  
...  
Keyword(s):  
Gestational Age ◽  
New South ◽  
New South Wales ◽  
South Wales

Gestational age, morbidity and mortality among twin births in New South Wales, Australia 2003–2014: A cohort study

2019 ◽  
Vol 60 (4) ◽  
pp. 541-547
Author(s):  
Ibinabo Ibiebele ◽  
Jacob B. Humphries ◽  
Siranda Torvaldsen ◽  
Jane B. Ford ◽  
Jonathan M. Morris ◽  
...  
Keyword(s):  
Cohort Study ◽  
Gestational Age ◽  
New South ◽  
New South Wales ◽  
Morbidity And Mortality ◽  
South Wales

scholarly journals Gestational age as a predictor for subsequent preterm birth in New South Wales, Australia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gavin Pereira ◽  
Annette K. Regan ◽  
Kingsley Wong ◽  
Gizachew A. Tessema
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
New South ◽  
Absolute Risk ◽  
New South Wales ◽  
Predictive Ability ◽  
Evidence Base ◽  
First Birth ◽  
Predictive Values ◽  
South Wales

Abstract Background There is no validated evidence base on predictive ability and absolute risk of preterm birth by gestational age of the previous pregnancy. Methods We conducted a retrospective cohort study of mothers who gave birth to their first two children in New South Wales, 1994–2016 (N = 517,558 mothers). For each week of final gestational age of the first birth, we calculated relative and absolute risks of subsequent preterm birth. Results For mothers whose first birth had a gestational age of 22 to 30 weeks the absolute risks of clinically significant preterm second birth (before 28, 32, and 34 weeks) were all less than 14%. For all gestational ages of the first child the median gestational ages of the second child were all at least 38 weeks. Sensitivity and positive predictive values were all below 30%. Conclusion Previous gestational age alone is a poor predictor of subsequent risk of preterm birth.

scholarly journals Trends in the Distribution of Gestational Age and Contribution of Planned Births in New South Wales, Australia

PLoS ONE ◽  
2013 ◽  
Vol 8 (2) ◽  
pp. e56238 ◽  
Author(s):  
Natasha Nassar ◽  
Michal Schiff ◽  
Christine L. Roberts
Keyword(s):  
Gestational Age ◽  
New South ◽  
New South Wales ◽  
South Wales

THE INFLUENCE OF ANTENATAL AND MATERNAL FACTORS ON STILLBIRTHS AND NEONATAL DEATHS IN NEW SOUTH WALES, AUSTRALIA

2005 ◽  
Vol 38 (5) ◽  
pp. 643-657 ◽  
Author(s):  
M. MOHSIN ◽  
A. E. BAUMAN ◽  
B. JALALUDIN
Keyword(s):  
Socioeconomic Status ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Antenatal Care ◽  
Gestational Age ◽  
New South ◽  
New South Wales ◽  
Neonatal Deaths ◽  
South Wales ◽  
Common Causes

This study identified the influences of maternal socio-demographic and antenatal factors on stillbirths and neonatal deaths in New South Wales, Australia. Bivariate and multivariate analyses were used to explore the association of selected antenatal and maternal characteristics with stillbirths and neonatal deaths. The findings of this study showed that stillbirths and neonatal deaths significantly varied by infant sex, maternal age, Aboriginality, maternal country of birth, socioeconomic status, parity, maternal smoking behaviour during pregnancy, maternal diabetes mellitus, maternal hypertension, antenatal care, plurality of birth, low birth weight, place of birth, delivery type, maternal deaths and small gestational age. First-born infants, twins and infants born to teenage mothers, Aboriginal mothers, those who smoked during the pregnancy and those of lower socioeconomic status were at increased risk of stillbirths and neonatal deaths. The most common causes of stillbirths were conditions originating in the perinatal period: intrauterine hypoxia and asphyxia. Congenital malformations, including deformities and chromosomal abnormalities, and disorders related to slow fetal growth, short gestation and low birth weight were the most common causes of neonatal deaths. The findings indicate that very low birth weight (less than 2000 g) contributed 75·6% of the population-attributable risks to stillbirths and 59·4% to neonatal deaths. Low gestational age (less than 32 weeks) accounted for 77·7% of stillbirths and 87·9% of neonatal deaths. The findings of this study suggest that in order to reduce stillbirths and neonatal deaths, it is essential to include strategies to predict and prevent prematurity and low birth weight, and that there is a need to focus on anti-smoking campaigns during pregnancy, optimizing antenatal care and other healthcare programmes targeted at the socially disadvantaged populations identified in this study.

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