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Risk factors for maternal morbidity in Victoria, Australia: a population-based study

OBJECTIVES: The aim of this analysis was to quantify the risk factors associated with maternal morbidity among women in Victoria, Australia, focusing particularly on sociodemographic factors. DESIGN: Case–control analysis. PARTICIPANTS: Data on all maternities in Victoria from 1 January 2006 to 31 D...

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Autores principales: Lindquist, Anthea C, Kurinczuk, Jennifer J, Wallace, Euan M, Oats, Jeremy, Knight, Marian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4550708/
https://www.ncbi.nlm.nih.gov/pubmed/26307615
http://dx.doi.org/10.1136/bmjopen-2015-007903
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author Lindquist, Anthea C
Kurinczuk, Jennifer J
Wallace, Euan M
Oats, Jeremy
Knight, Marian
author_facet Lindquist, Anthea C
Kurinczuk, Jennifer J
Wallace, Euan M
Oats, Jeremy
Knight, Marian
author_sort Lindquist, Anthea C
collection PubMed
description OBJECTIVES: The aim of this analysis was to quantify the risk factors associated with maternal morbidity among women in Victoria, Australia, focusing particularly on sociodemographic factors. DESIGN: Case–control analysis. PARTICIPANTS: Data on all maternities in Victoria from 1 January 2006 to 31 December 2008. METHODS: A case–control analysis was conducted using unconditional logistic regression to calculate adjusted ORs (aORs). Cases were defined as all women noted to have had a severe complication during the index pregnancy. Severe maternal morbidity was defined by the validated, composite Australian Maternal Morbidity Outcome Indicator. Socioeconomic position was defined by Socio-Economic Indices for Areas (SEIFA), specifically the Index of Relative Socioeconomic Disadvantage (IRSD), and other variables analysed were age, parity, Indigenous background, multiple pregnancy, country of birth, coexisting medical condition, previous caesarean section, spontaneous abortion or ectopic pregnancy. RESULTS: The study population comprised 211 060 women, including 1119 cases of severe maternal morbidity (0.53%). Compared with the highest IRSD quintile, the aOR for the 2nd quintile was 1.23 (95% CI 1.03 to 1.49), 0.98 (95% CI 0.79 to 1.21) for the 3rd quintile, 1.55 (95% CI 1.28 to 1.87) for the 4th and 1.21 (95% CI 1.00 to 1.47) for the lowest (most deprived) quintile. Indigenous status was associated with twice (aOR 2.02; 95% CI 1.32 to 3.09) the odds of being a case. Other risk factors for severe maternal morbidity were age ≥35 years (aOR 1.22; 95% CI 1.04 to 1.44), coexisting medical condition (aOR 1.39; 95% CI 1.16 to 1.65), multiple pregnancy (aOR 2.30; 95% CI 1.71 to 3.10), primiparity (aOR 1.36; 95% CI 1.18 to 1.57), previous caesarean section (aOR 1.79; 95% CI 1.53 to 2.10) and previous spontaneous miscarriage (aOR 1.25; 95% CI 1.08 to 1.44). CONCLUSIONS: The findings from Victoria strongly suggest that social disadvantage needs to be acknowledged and further investigated as an independent risk factor for adverse maternal outcomes in Australia and incorporated into appropriate policy planning and healthcare programmes.
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spelling pubmed-45507082015-08-31 Risk factors for maternal morbidity in Victoria, Australia: a population-based study Lindquist, Anthea C Kurinczuk, Jennifer J Wallace, Euan M Oats, Jeremy Knight, Marian BMJ Open Obstetrics and Gynaecology OBJECTIVES: The aim of this analysis was to quantify the risk factors associated with maternal morbidity among women in Victoria, Australia, focusing particularly on sociodemographic factors. DESIGN: Case–control analysis. PARTICIPANTS: Data on all maternities in Victoria from 1 January 2006 to 31 December 2008. METHODS: A case–control analysis was conducted using unconditional logistic regression to calculate adjusted ORs (aORs). Cases were defined as all women noted to have had a severe complication during the index pregnancy. Severe maternal morbidity was defined by the validated, composite Australian Maternal Morbidity Outcome Indicator. Socioeconomic position was defined by Socio-Economic Indices for Areas (SEIFA), specifically the Index of Relative Socioeconomic Disadvantage (IRSD), and other variables analysed were age, parity, Indigenous background, multiple pregnancy, country of birth, coexisting medical condition, previous caesarean section, spontaneous abortion or ectopic pregnancy. RESULTS: The study population comprised 211 060 women, including 1119 cases of severe maternal morbidity (0.53%). Compared with the highest IRSD quintile, the aOR for the 2nd quintile was 1.23 (95% CI 1.03 to 1.49), 0.98 (95% CI 0.79 to 1.21) for the 3rd quintile, 1.55 (95% CI 1.28 to 1.87) for the 4th and 1.21 (95% CI 1.00 to 1.47) for the lowest (most deprived) quintile. Indigenous status was associated with twice (aOR 2.02; 95% CI 1.32 to 3.09) the odds of being a case. Other risk factors for severe maternal morbidity were age ≥35 years (aOR 1.22; 95% CI 1.04 to 1.44), coexisting medical condition (aOR 1.39; 95% CI 1.16 to 1.65), multiple pregnancy (aOR 2.30; 95% CI 1.71 to 3.10), primiparity (aOR 1.36; 95% CI 1.18 to 1.57), previous caesarean section (aOR 1.79; 95% CI 1.53 to 2.10) and previous spontaneous miscarriage (aOR 1.25; 95% CI 1.08 to 1.44). CONCLUSIONS: The findings from Victoria strongly suggest that social disadvantage needs to be acknowledged and further investigated as an independent risk factor for adverse maternal outcomes in Australia and incorporated into appropriate policy planning and healthcare programmes. BMJ Publishing Group 2015-08-25 /pmc/articles/PMC4550708/ /pubmed/26307615 http://dx.doi.org/10.1136/bmjopen-2015-007903 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Obstetrics and Gynaecology
Lindquist, Anthea C
Kurinczuk, Jennifer J
Wallace, Euan M
Oats, Jeremy
Knight, Marian
Risk factors for maternal morbidity in Victoria, Australia: a population-based study
title Risk factors for maternal morbidity in Victoria, Australia: a population-based study
title_full Risk factors for maternal morbidity in Victoria, Australia: a population-based study
title_fullStr Risk factors for maternal morbidity in Victoria, Australia: a population-based study
title_full_unstemmed Risk factors for maternal morbidity in Victoria, Australia: a population-based study
title_short Risk factors for maternal morbidity in Victoria, Australia: a population-based study
title_sort risk factors for maternal morbidity in victoria, australia: a population-based study
topic Obstetrics and Gynaecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4550708/
https://www.ncbi.nlm.nih.gov/pubmed/26307615
http://dx.doi.org/10.1136/bmjopen-2015-007903
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