Aboriginal teenage pregnancies compared with non-Aboriginal in South Australia 1995-1999

Abstract

OBJECTIVE: To compare pregnancy characteristics and outcomes between Aboriginal and non-Aboriginal teenagers. DESIGN, SETTING AND POPULATION: A retrospective cohort study using the perinatal data collection for South Australian births in 1995–1999: 449 Aboriginal and 4625 non-Aboriginal teenagers. METHODS: Comparison of socio-demographic and clinical characteristics, using relative risks. MAIN OUTCOME MEASURES: Rates of pregnancy, smoking during pregnancy, induction, delivery method, preterm and small-for-gestational-age births and perinatal mortality. RESULTS: Aboriginal teenagers have a pregnancy rate more than twice as high as non-Aboriginal, but a smaller proportion of pregnancies are terminated. They have pregnancies earlier, are more likely to be single, to smoke during pregnancy, to have few antenatal visits, to give birth in a country hospital and to have infections and anaemia. They have lower induction and analgesia rates, but a higher caesarean section rate. Their babies are more likely to be small-for-gestational-age and preterm, to have a congenital abnormality, to require special and intensive nursery care and stay longer in hospital. While their perinatal mortality rate has halved since a decade ago, their neonatal death rate is still twice that of non-Aboriginal births. CONCLUSIONS: Aboriginal teenagers need special attention. Support in particular is needed for Aboriginal health workers in preconceptional counselling and health promotion programs that build the capacity of the community, eg concerning proper nutrition during pregnancy, smoking cessation, breastfeeding, SIDS prevention, support for early and regular attendance for antenatal care in friendly and culturally appropriate environments. Outreach services and sexual health services for young Aboriginal people also need expansion.