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BABIES AND CHILDREN
The main reason for the difference in the number of Indigenous births identified in the ABS Births Registration Collection and the NPDC is that the latter does not collect paternal information and therefore only births to Indigenous mothers are identified as Indigenous births. Other differences between the two collections include the different methodologies used to collect information, and delays in the registration of, or failure to register, some live births (AIHW: Leeds et al 2007).
Gestational age is the length of a pregnancy in completed weeks. The gestational age at birth for term pregnancies is between 37 and 41 weeks; for preterm births it is less than 37 weeks. Preterm birth is associated with neonatal problems that cause significant morbidity and mortality in newborn babies. In the period 2001-2004, there were 4,962 preterm babies born to Indigenous mothers, representing 14% of all births to Indigenous mothers. This was almost double the rate of preterm births among non-Indigenous mothers (8%) in the same period (AIHW: Leeds et al 2007).
A baby's birthweight is a key indicator of health status. Babies born with a birthweight of less than 2,500 grams are classified as 'low birthweight'. Low birthweight may be a result of preterm birth, foetal growth restriction, or a combination of the two. Low birthweight babies are at greater risk of poor health and death, require longer periods of hospitalisation after birth, and are more likely to develop significant disabilities (Goldenberg & Culhane 2007). Some factors that contribute to low birthweight are socioeconomic disadvantage, size of parents, age of the mother, number of babies previously born, mother's nutritional status, smoking and alcohol intake, and illness during pregnancy (Ashdown-Lambert 2005; Moshin et al 2003).
In 2001-04 there were 4,578 low birthweight babies born to Indigenous mothers, representing 13% of liveborn babies to Indigenous mothers. This was more than double the proportion of low birthweight live born babies with non-Indigenous mothers (6%) (AIHW: Leeds et al 2007).
Data from 1991 to 2004 show a significant increase in the rate of low birthweight babies among singleton live births to Indigenous mothers, from 11.1 to 12.1 per 100 live births (graph 6.6). There was also a significant, but much smaller increase in the proportion of low birthweight babies born to non-Indigenous mothers over this period from 4.5 to 4.6 per 100 live births (AIHW Leeds et al 2007). Some of the increase in the proportion of low birthweight babies born to Indigenous mothers may be the result of improved identification of Indigenous mothers over time.
Perinatal deaths include both foetal deaths (stillbirths) and deaths of liveborn babies within the first 28 days after birth. These deaths are almost all due to factors during pregnancy and childbirth. Perinatal mortality reflects the health status of the population as well as their access to quality health care.
Data on perinatal deaths are available from the ABS Deaths Registration Collection and the NPDC. Data from the ABS Deaths Registration Collection have been presented here, as babies born to both Indigenous mothers and fathers are identified in this dataset. The identification of Indigenous status in deaths registration data has been assessed by the ABS and AIHW as having a sufficient level of coverage to enable statistics on Aboriginal and Torres Strait Islander mortality to be produced in four jurisdictions - Queensland, Western Australia, South Australia and the Northern Territory (ABS & AIHW 2005). Long-term mortality trend data are limited to three jurisdictions - Western Australia, South Australia and the Northern Territory, which have over 10 years of adequate identification of Indigenous deaths in their recording systems.
Over the period 2003-2005, there were 350 perinatal deaths of Indigenous infants in the four jurisdictions. The 2003-2005 rate of perinatal deaths in the four jurisdictions was 15.7 per 1,000 births for Indigenous babies compared with 10.3 per 1,000 births for non-Indigenous babies.
There was a significant decline in the perinatal death rate for Aboriginal and Torres Strait Islander babies in Western Australia from 20 per 1,000 births in the period 1991-1993 to 13 per 1,000 births in 2003-2005 (table 6.7).