Abstract
BackgroundSignificant health inequities exist around maternal and infant health for Māori, the indigenous people of Aotearoa New Zealand – and in particular around a premature (preterm) delivery. Māori babies are more likely to be born preterm (8.1%, compared to an overall rate of 7.4%) and they are more likely to have a preterm death. An essential part of redressing these disparities is to examine the clinical care pathway and outcomes associated with preterm deliveries. This paper describes a protocol utilising national and local health collections to enable such a study.DesignThis is a retrospective cohort study comprising 5 years data pertaining to preterm deliveries from 2010 to 2014. These data are generated from linked national administrative and local health information collections to explore a range of neonatal outcomes and infant mortality in relation to the antenatal care pathway and known risk factors for preterm delivery. This study is being conducted within a Kaupapa Māori paradigm that dismisses victim blaming and seeks to intervene at structural levels to improve the health and wellbeing of Māori whānau (family).Significance of the studyOur data-linkage methodology optimises the utility of New Zealand health collections to address a significant health issue. Our findings will fill the information gaps around the burden of preterm delivery by quantifying the incidence of preterm delivery and adverse neonatal and infant outcomes in Aotearoa New Zealand. It will explore access to evidenced based care including use of steroids before birth, and appropriate place of delivery. The results from this study will inform maternity care services to improve management of preterm deliveries – both locally and internationally. This in turn will improve the preterm sequela by reducing the long-term health burden and health inequities.
Highlights
Significant health inequities exist around maternal and infant health for Māori, the indigenous people of Aotearoa New Zealand – and in particular around a premature delivery
Significance of the study: Our data-linkage methodology optimises the utility of New Zealand health collections to address a significant health issue
This paper describes the protocol for a retrospective cohort study that links local hospital, community laboratories and national health information datasets to explore the preterm delivery clinical care pathway, delivery and neonatal outcomes and infant mortality (≤ 1 yr. of age) of Māori and Pākehā (New Zealand European) women and their babies
Summary
Significant health inequities exist around maternal and infant health for Māori, the indigenous people of Aotearoa New Zealand – and in particular around a premature (preterm) delivery. This paper describes the protocol for a retrospective cohort study that links local hospital, community laboratories and national health information datasets to explore the preterm delivery clinical care pathway, delivery and neonatal outcomes and infant mortality Preterm deliveries in Aotearoa New Zealand A premature delivery (preterm) can potentially result in adverse outcomes such as death, brain haemorrhage, Filoche et al BMC Health Services Research (2018) 18:374 infection, chronic lung disease and long-term growth impairment and harm including cerebral palsy, cognitive, visual and learning impairments [10,11,12,13,14]. This paper describes a protocol utilising local and national administrative health collections to enable such a study
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