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

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.

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

Journal of Biosocial Science ◽

10.1017/s002193200502701x ◽

2005 ◽

Vol 38 (5) ◽

pp. 643-657 ◽

Cited By ~ 24

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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