期刊
PAEDIATRIC AND PERINATAL EPIDEMIOLOGY
卷 32, 期 1, 页码 114-125出版社
WILEY
DOI: 10.1111/ppe.12426
关键词
gestational age; preterm birth; early childhood development; indigenous population; linked administrative data
资金
- Australian National Health and Medical Research Council (NHMRC) [10617133]
- NHMRC Early Career Fellowship [1016475]
- NHMRC capacity building grant [573122]
- NHMRC Senior Research Fellowship [1042717]
- National Health and Medical Research Council of Australia [1056888]
- Centre of Research Excellence [1099422]
- NHMRC Career Development Fellowship [1013418]
- Manitoba Centre for Health Policy Population-Based Child Health Research Award
BackgroundPreterm birth and developmental vulnerability are more common in Australian Aboriginal compared with non-Aboriginal children. We quantified how gestational age relates to developmental vulnerability in both populations. MethodsPerinatal datasets were linked to the Australian Early Development Census (AEDC), which collects data on five domains, including physical, social, emotional, language/cognitive, and general knowledge/communication development. We quantified the risk of developmental vulnerability on 1 domains at age 5, according to gestational age and Aboriginality, for 97989 children born in New South Wales, Australia, who started school in 2009 or 2012. ResultsSeven thousand and seventy-nine children (7%) were Aboriginal. Compared with non-Aboriginal children, Aboriginal children were more likely to be preterm (5% vs. 9%), and developmentally vulnerable on 1 domains (20% vs. 36%). Overall, the proportion of developmentally vulnerable children decreased with increasing gestational age, from 44% at 27weeks to 20% at 40weeks. Aboriginal children had higher risks than non-Aboriginal children across the gestational age range, peaking among early term children (risk difference [RD] 19.0, 95% confidence interval [CI] 16.3, 21.7; relative risk [RR] 1.91, 95% CI 1.77, 2.06). The relation of gestational age to developmental outcomes was the same in Aboriginal and non-Aboriginal children, and adjustment for socio-economic disadvantage attenuated the risk differences and risk ratios across the gestational age range. ConclusionsAlthough the relation of gestational age to developmental vulnerability was similar in Aboriginal and non-Aboriginal children, Aboriginal children had a higher risk of developmental vulnerability at all gestational ages, which was largely accounted for by socio-economic disadvantage.
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