Indigenous women and their babies
The data presented in this chapter are reported by maternal Indigenous status—that is babies born to women who identify as Aboriginal and/or Torres Strait Islander.
There has been a change in the rate of perinatal death for babies born to Indigenous women between 2005 and 2016, with rates dropping from 19.1 to 14.7 deaths per 1,000 births, respectively. This trend is more apparent in neonatal deaths, with rates dropping from 7.4 to 4.3 deaths per 1,000 live births, respectively.
In 2015 and 2016, perinatal deaths among babies born to Indigenous women:
- accounted for 362 perinatal deaths (13.4 per 1,000 births), 4.3% of all births and 6.3% of all perinatal deaths (6.0% of stillbirths and 7.4% of neonatal deaths).
- were higher for babies born to Torres Strait Islander women compared to babies born to Aboriginal women and babies born to women who identify as both Aboriginal and Torres Strait Islander.
- were less common in women aged between 25 and 29 had (10.9 per 1,000 births).
- increased with increasing remoteness.
- occurred more frequently for women who reported smoking during pregnancy compared to women who did not smoke (14.5 and 12.0 per 1,000 births, respectively).
- were more than twice as common among babies born to women who had pre-existing diabetes than to women who had no diabetes (30.2 and 14.8 per 1,000 births, respectively).
- were highest among women who were underweight, with a BMI of less than 18.5 (20.4 per 1,000 births).
- were more frequent in babies who were small for gestational age than in babies whose birthweights were appropriate for gestational age (22.3 and 10.8 per 1,000 births, respectively).
- decreased with increasing gestational age, particularly from more than 26 weeks gestation.
Timing and causes of perinatal death
The most commonly classified causes of perinatal deaths among babies born to Indigenous women were:
- Congenital anomaly (19.6%)
- Spontaneous preterm birth (19.6%)
- Unexplained antepartum death (15.5%).
In babies born to Indigenous women, half (50.4%) of perinatal deaths occurred prior to the onset of labour (antepartum stillbirths).
Investigation following perinatal death
Autopsy
Of the 362 perinatal deaths among babies born to Indigenous women, 345 had a stated autopsy status. Of deaths where autopsy status was stated in 2015 and 2016:
- Autopsies were performed less frequently for perinatal deaths of babies born to Indigenous women (39.4%) than for perinatal deaths occurring across all babies (41.1%).
- Autopsies were most commonly performed for perinatal deaths of babies born to Indigenous women where the cause of death was no obstetric antecedent, fetal growth restriction or hypertension.
Placental examination
Data on placental histology examinations are not available for Queensland, Western Australia or South Australia. Data from these states have been excluded from analysis (refer to Data quality and availability of national perinatal mortality data for more information).
Of the 362 perinatal deaths among babies born to Indigenous women in 2015 and 2016, there were 161 from News South Wales, Victoria, Tasmania, Australia Capital Territory where placental histology status was stated. Of deaths where placental histology status was stated:
- Placental histological examinations were performed for 91.9% of perinatal deaths among babies born to Indigenous women, which was a higher incidence than that seen across all perinatal deaths (80.9%).