PREGNANCY OUTCOMES IN URBAN ABORIGINAL WOMEN

Objective: To assess Aboriginal women's access to antenatal care and t heir pregnancy outcomes in an urban setting. Design: Retrospective des criptive study using an obstetric database. Setting: King George V Mem orial Hospital, Sydney. Patients: All women Who gave birth between 1 J anuary 1992 and 31 December 1993. Outcome measures: Age and parity, ge station at first antenatal visit and at delivery, antenatal complicati ons, type of delivery, infant birthweights and perinatal mortality wer e compared between Aboriginal and non-Aboriginal women. Within the Abo riginal group, comparisons were made between those with and without po or pregnancy outcomes (low birthweight infants and perinatal deaths). Results: Aboriginal women were younger and of higher parity than non-A boriginal women and booked for confinement later in pregnancy, althoug h nearly 80% were booked by 28 weeks' gestation. There was more pregna ncy-induced hypertension (P < 0.01; relative risk [RR], 1.66; 95% conf idence interval [CI], 1.17-2.37), urinary tract infection (P < 0.02; R R, 2.45; 95% CI, 1.27-4.30) and need for methadone stabilisation in Ab original women (P < 0.001; RR, 5.88; 95% CI, 2.99-11.57). In the Abori ginal group, there were higher preterm delivery rates (P < 0.001; 95% CI, 1.31-2.74), more low birthweight babies (P < 0.001; 95% CI, 1.67-3 .33) and higher perinatal mortality rates. These findings applied to b oth Aboriginal women transferred from metropolitan district and countr y hospitals and those resident in central Sydney. Factors associated w ith low birthweight and perinatal deaths in Aboriginal infants include d late antenatal booking, cigarette smoking, hypertension and urinary tract infection in pregnancy, and antepartum haemorrhage. Conclusion: Further efforts must be made to improve access of Aboriginal women to antenatal services in the Central Sydney Area to improve perinatal out comes and maternal health.