Elsevier

Annals of Epidemiology

Volume 5, Issue 5, September 1995, Pages 393-399
Annals of Epidemiology

Original report
An investigation into the disparity between Australian Aboriginal and Caucasian perinatal mortality rates

https://doi.org/10.1016/1047-2797(95)00037-8Get rights and content

Abstract

The babies of Australian Aboriginal mothers have higher overall perinatal mortality rates than the babies of Caucasian mothers. They are also more likely to be preterm and of low birth weight. This study used Poisson regression models to adjust the perinatal mortality rates for differences in the gestational age and birth weight distributions of Aborigines and Caucasians. The intriguing finding was that full-term Aboriginal neonates (the group at lowest absolute risk) fare particularly poorly in comparison with Caucasian (adjusted relative risk: 2.9; 95% confidence interval: 1.5 to 5.5). Possible explanations for this phenomenon are explored.

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      Prospective ORs help avoid potentially biased associations at preterm gestational ages from models that are stratified by gestational age.11 Stillbirths and preterm births share unmeasured risk factors, and regression of data stratified by gestational age can unintentionally make stillbirths appear more (or less) healthy than live preterm births,12,13 thus biasing results and rendering many previous studies difficult to interpret.14,15 Odds ratios from stratified models can also be attenuated or amplified by the underlying rates of preterm live births of Aboriginal subgroups.

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