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Community Remoteness, Perinatal Outcomes and Infant Mortality among First Nations in Quebec

OBJECTIVE: Little is known about community remoteness in relation to birth outcomes among Indigenous populations. We assessed whether community remoteness matters for perinatal outcomes and infant mortality in Quebec First Nations communities. STUDY DESIGN: A retrospective cohort study of all births...

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Autores principales: Wassimi, Spogmai, Mchugh, Nancy G. L., Wilkins, Russell, Heaman, Maureen, Martens, Patricia, Smylie, Janet, Simonet, Fabienne, Fraser, William D, Luo, Zhong-Cheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3265536/
https://www.ncbi.nlm.nih.gov/pubmed/22282717
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author Wassimi, Spogmai
Mchugh, Nancy G. L.
Wilkins, Russell
Heaman, Maureen
Martens, Patricia
Smylie, Janet
Simonet, Fabienne
Fraser, William D
Luo, Zhong-Cheng
author_facet Wassimi, Spogmai
Mchugh, Nancy G. L.
Wilkins, Russell
Heaman, Maureen
Martens, Patricia
Smylie, Janet
Simonet, Fabienne
Fraser, William D
Luo, Zhong-Cheng
author_sort Wassimi, Spogmai
collection PubMed
description OBJECTIVE: Little is known about community remoteness in relation to birth outcomes among Indigenous populations. We assessed whether community remoteness matters for perinatal outcomes and infant mortality in Quebec First Nations communities. STUDY DESIGN: A retrospective cohort study of all births (n=11,033) to residents of First Nations communities in Quebec 1991–2000, using linked vital statistics data. First Nations communities were grouped by community remoteness into four zones from the least to most remote. RESULTS: Preterm birth rates declined progressively from the least remote (8.0%) to the most remote (5.7%) zones (p=0.002). In contrast, total fetal and infant mortality rose progressively from the least remote (10.4 per 1000) to the most remote (22.7 per 1000) zones (p<0.001). The excess infant mortality in the more remote zones was mainly due to higher rates of postneonatal mortality. Similar patterns were observed after adjusting for maternal age, education, parity and marital status. Substantially elevated risks in most remote communities remained for perinatal death (adjusted OR=2.1), postneonatal death (adjusted OR=2.7), and total fetal and infant death (adjusted OR=2.3). CONCLUSION: Living in more remote First Nations communities was associated with a substantially higher risk of fetal and infant death, especially postneonatal death, despite a lower risk of preterm delivery. There is a need for more effective perinatal and infant care programs in more remote First Nations communities to reduce perinatal and infant mortality.
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spelling pubmed-32655362012-01-24 Community Remoteness, Perinatal Outcomes and Infant Mortality among First Nations in Quebec Wassimi, Spogmai Mchugh, Nancy G. L. Wilkins, Russell Heaman, Maureen Martens, Patricia Smylie, Janet Simonet, Fabienne Fraser, William D Luo, Zhong-Cheng Open Womens Health J Article OBJECTIVE: Little is known about community remoteness in relation to birth outcomes among Indigenous populations. We assessed whether community remoteness matters for perinatal outcomes and infant mortality in Quebec First Nations communities. STUDY DESIGN: A retrospective cohort study of all births (n=11,033) to residents of First Nations communities in Quebec 1991–2000, using linked vital statistics data. First Nations communities were grouped by community remoteness into four zones from the least to most remote. RESULTS: Preterm birth rates declined progressively from the least remote (8.0%) to the most remote (5.7%) zones (p=0.002). In contrast, total fetal and infant mortality rose progressively from the least remote (10.4 per 1000) to the most remote (22.7 per 1000) zones (p<0.001). The excess infant mortality in the more remote zones was mainly due to higher rates of postneonatal mortality. Similar patterns were observed after adjusting for maternal age, education, parity and marital status. Substantially elevated risks in most remote communities remained for perinatal death (adjusted OR=2.1), postneonatal death (adjusted OR=2.7), and total fetal and infant death (adjusted OR=2.3). CONCLUSION: Living in more remote First Nations communities was associated with a substantially higher risk of fetal and infant death, especially postneonatal death, despite a lower risk of preterm delivery. There is a need for more effective perinatal and infant care programs in more remote First Nations communities to reduce perinatal and infant mortality. 2010-01-01 /pmc/articles/PMC3265536/ /pubmed/22282717 Text en This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
spellingShingle Article
Wassimi, Spogmai
Mchugh, Nancy G. L.
Wilkins, Russell
Heaman, Maureen
Martens, Patricia
Smylie, Janet
Simonet, Fabienne
Fraser, William D
Luo, Zhong-Cheng
Community Remoteness, Perinatal Outcomes and Infant Mortality among First Nations in Quebec
title Community Remoteness, Perinatal Outcomes and Infant Mortality among First Nations in Quebec
title_full Community Remoteness, Perinatal Outcomes and Infant Mortality among First Nations in Quebec
title_fullStr Community Remoteness, Perinatal Outcomes and Infant Mortality among First Nations in Quebec
title_full_unstemmed Community Remoteness, Perinatal Outcomes and Infant Mortality among First Nations in Quebec
title_short Community Remoteness, Perinatal Outcomes and Infant Mortality among First Nations in Quebec
title_sort community remoteness, perinatal outcomes and infant mortality among first nations in quebec
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3265536/
https://www.ncbi.nlm.nih.gov/pubmed/22282717
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