Success in Closing the Gap: favourable neonatal outcomes in a metropolitan Aboriginal Maternity Group Practice Program

Objectives: To report differences in neonatal health outcomes for a community-based antenatal program, the Aboriginal Maternity Group Practice Program (AMGPP; the intervention group), compared with two matched control groups eligible for standard antenatal care. Design: Non-randomised intervention study using data from the Western Australian Midwives Notification System. Regression models were used to report adjusted odds ratios (aORs) for defined neonatal health outcomes. Setting: The AMGPP employed Aboriginal grandmothers, Aboriginal Health Officers, and midwives working in partnership with existing antenatal services to provide care for pregnant Aboriginal women residing in south metropolitan Perth. Participants: 343 women (with 350 pregnancies) who participated in the AMGPP and gave birth between 1 July 2011 and 31 December 2012; historical and contemporary control groups of pregnant Aboriginal women (each including 350 pregnancies), frequency matched for maternal age and gravidity. Main outcome measures: Preterm births, birthweight, neonatal resuscitation, neonatal hospital length of stay longer than 5 days. Results: Babies born to AMGPP participants were significantly less likely to be born preterm (AMGPP, 9.1% v historical controls, 15.9% [aOR, 0.56; 95% CI, 0.35-0.92]; v contemporary controls, 15.3% [aOR, 0.75; 95% CI, 0.58-0.95]); to require resuscitation at birth (AMGPP, 17.8% v historical controls, 24.4% [aOR, 0.68; 95% CI, 0.47-0.98]; v contemporary controls, 31.2% [aOR, 0.71; 95% CI, 0.60-0.85]), or to have a hospital length of stay of more than 5 days (AMGPP, 4.0% v historical controls, 11.3% [aOR, 0.34; 95% CI, 0.18-0.64]; v contemporary controls, 11.6% [aOR, 0.56; 95% CI, 0.41-0.77]). Conclusion: Participation in the AMGPP in south metropolitan Perth was associated with significantly improved neonatal health outcomes.