Obstetric profiles and perinatal mortality among Pacific Island immigrantsin New South Wales, 1990-93

Objectives: To describe the obstetric profile and perinatal mortality of Pa cific island-born women giving birth in New South Wales (NSW) and assess ri sk factors associated with the high perinatal death rate previously noted i n this immigrant group. Method: Retrospective cohort study based on the Midwives Data Collection in NSW from 1990 to 1993. Births to 5,034 Pacific Island-born women were comp ared with births to 256,843 Australian-born women. Results: Pacific Island-born women had fewer teenage pregnancies and were o f an older age and higher parity. They were more likely to be married or in a de facto relationship and to present for antenatal care later in the pre gnancy. The proportion of low birthweight and preterm birth was similar in the two groups but Pacific Islanders had st higher perinatal mortality rate (14.6/1,000 vs. 10.3/1,000, RR = 1.42, 95% ct = 1.13-1.54). Even at normal and high birthweights, infants of Pacific Island-born women were at greater risk of perinatal death. After adjusting for maternal facto rs (marital status, insurance status. parity and maternal age) Pacific Isla nders were 30% more likely to have a perinatal death (OR = 1.30, 95% CI 1.0 7-1.54). Conclusions: Further analyses of the causes of perinatal death in Pacific I sland-born women are needed so appropriate interventions can be implemented . Implications: The need for the design and evaluation of culturally specific services aimed at improving antenatal care attendance in Pacific Islanders is emphasised. Conventional risk assessment may not adequately predict adv erse perinatal outcomes in all populations.