Summary
Timely and frequent antenatal care is key to improving health outcomes for both mothers and babies. This report explores the factors associated with antenatal care use among Aboriginal and Torres Strait Islander mothers, and how these may relate to baby outcomes – including how this varies spatially across the Indigenous Regions of Australia.
Antenatal care use varies geographically
The use of antenatal care varies across the Indigenous Regions of Australia. In the 2-year period 2016–2017:
- 63% of Indigenous mothers attended antenatal care in the first trimester – an increase from 55% in 2014–2015.
- across 37 Indigenous Regions, the proportion of Indigenous mothers attending antenatal care in the first trimester ranged from 40% to 84%.
Timing of antenatal care use associated with birth outcomes
Antenatal care in the first trimester has a positive impact on baby outcomes. After adjusting for a range of factors, an analysis showed that:
- Having the first antenatal visit after the first trimester was associated with increased odds of low birthweight and neonatal intensive care unit/special care nursery (NICU/SCN) admission.
- Having no antenatal care was associated with increased odds of pre-term birth and perinatal death.
Regional variation in antenatal care use and outcomes
To explore regional variation in antenatal care use and outcomes, 7 different measures were analysed by Indigenous Region: antenatal care in the first trimester, 5+ antenatal care visits, smoking during pregnancy, pre-existing diabetes, pregnancy-induced hypertension, low birthweight and pre-term births. This showed that:
- Indigenous Regions that had higher proportions of mothers accessing antenatal care, were more likely to have lower rates of adverse mother and baby outcomes.
- 3 of the 4 best performing Indigenous Regions (North-Eastern NSW, NSW Central and North Coast, Brisbane) were clustered along the centre of the east coast, with Broome being the fourth Indigenous Region.
Summary
1. Introduction
- Methods and variables used in analysis
- Overview of antenatal care use
- Report structure
2. Aboriginal and Torres Strait Islander mothers
- Selected characteristics
- Maternal age
- Remoteness
- Social determinants of health
- Maternal smoking
- Pre-pregnancy BMI
- Diabetes
- Hypertension
- Antepartum haemorrhage
- Parity
- Mother’s characteristics and antenatal care use
- Broad findings
- Attending antenatal care in the first trimester
- Attending 5 or more antenatal visits throughout pregnancy
3. Babies born to Aboriginal and Torres Strait Islander mothers
- Selected birth and early infanthood outcomes
- Pre-term birth
- Low birthweight
- Neonatal intensive care unit/special care nursery
- Perinatal deaths
- Association between selected factors and birth outcomes
- Effects of antenatal care
- Baby outcomes
- Spatial variation in antenatal care use, baby outcomes and selected risk factors
- Analysis method
- Spatial variation in outcomes
Appendix A: Data tables
Appendix B: National Perinatal Data Collection
End matter: Acknowledgments; Abbreviations; Symbols; Glossary; References