A retrospective population-based study of induction of labour trends and associated factors among aboriginal and non-aboriginal mothers in the northern territory between 2001 and 2012

Pasqualina Coffey; John Condon; Karen Dempsey; Steven Guthridge; Fintan Thompson

doi:10.1186/s12884-016-0899-7

A retrospective population-based study of induction of labour trends and associated factors among aboriginal and non-aboriginal mothers in the northern territory between 2001 and 2012

BMC Pregnancy Childbirth. 2016 May 31;16(1):126. doi: 10.1186/s12884-016-0899-7.

Authors

Pasqualina Coffey¹, John Condon^{2

3}, Karen Dempsey^{2

3}, Steven Guthridge^{2

3}, Fintan Thompson^{2

4}

Affiliations

¹ Health Gains Planning Branch, Department of Health, Darwin, Australia. [email protected].
² Health Gains Planning Branch, Department of Health, Darwin, Australia.
³ Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
⁴ Centre for Chronic Disease Prevention, The Cairns Institute, James Cook University, Cairns, Australia.

Abstract

Background: Induction of labour (IOL) has become more common among many populations, but the trends and drivers of IOL in the Northern Territory (NT) of Australia are not known. This study investigated trends in IOL and associated factors among NT Aboriginal and non-Aboriginal mothers between 2001 and 2012.

Methods: A retrospective analysis of all NT resident women who birthed in the NT between 2001 and 2012 at ≥32 weeks gestation. Demographic, medical and obstetric data were obtained from the NT Midwives' Collection. The prevalence of IOL was calculated by Aboriginal status and parity of the mother and year of birth. The prevalence of each main indication for induction among women was compared for 2001-2003 and 2010-2012. Linear and logistic regression was used to test for association between predictive factors and IOL in bivariate and multivariate analysis, separately for Aboriginal and non-Aboriginal mothers.

Results: A total of 42,765 eligible births between 2001 and 2012 were included. IOL was less common for Aboriginal than non-Aboriginal mothers in 2001 (18.0 % and 25.1 %, respectively), but increased to be similar to non-Aboriginal mothers in 2012 (22.6 % and 24.8 %, respectively). Aboriginal primiparous mothers demonstrated the greatest increase in IOL. The most common indication for IOL for both groups was post-dates, which changed little over time. Medical and obstetric complications were more common for Aboriginal mothers except late-term pregnancy. Prevalence of diabetes in pregnancy increased considerably among both Aboriginal and non-Aboriginal mothers, but was responsible for only a small proportion of IOLs. Increasing prevalence of risk factors did not explain the increased IOL prevalence for Aboriginal mothers.

Conclusions: IOL is now as common for Aboriginal as non-Aboriginal mothers, though their demographic, medical and obstetric profiles are markedly different. Medical indications did not explain the recent increase in IOL among Aboriginal mothers; changes in maternal or clinical decision-making may have been involved.

Keywords: Indigenous; Induction of labour; Pregnancy.

MeSH terms

Adult
Female
Humans
Labor, Induced / trends*
Multivariate Analysis
Northern Territory / epidemiology
Northern Territory / ethnology
Pregnancy
Pregnancy Complications / epidemiology*
Pregnancy Complications / ethnology*
Prevalence
Regression Analysis
Retrospective Studies
Risk Factors
Young Adult