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

Abstract

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. 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. 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. 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. Preterm births, birthweight, neonatal resuscitation, neonatal hospital length of stay longer than 5 days. 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]). Participation in the AMGPP in south metropolitan Perth was associated with significantly improved neonatal health outcomes.