Sudden infant death syndrome risk factors in North Queensland: a survey of infant care practices in Indigenous and non-Indigenous women

OBJECTIVE: To assess the prevalence of sudden infant death syndrome (SIDS) risk factors in the Indigenous and non-Indigenous community of Townsville, a large remote urban centre in north Queensland, Australia.\ud \ud METHODS: Thirty Indigenous and 30 non-Indigenous women with young children were surveyed using sections of the West Australian Infancy and Pregnancy Survey 1997-1998. The prevalence of SIDS risk factors was compared between the two groups and medians and univariate associations were generated where appropriate.\ud \ud RESULTS: The Indigenous women were significantly younger and more likely to be single. The median age of the infants was 8 months (range 0.3-26 months) with no difference between the two groups. Thirty-seven per cent of Indigenous infants slept prone (cf. 17% of non-Indigenous infants; P = 0.03), and 77% shared a bed (cf. 13% of non-Indigenous infants; P < 0.001). The Indigenous households had significantly more members, with 57% including extended family members (cf. 20% non-Indigenous group; P = 0.003). Fifty-three per cent of the Indigenous women smoked during pregnancy (cf. 23% of non-Indigenous women; P = 0.017), 60% were smokers at the time of the interview, and smoking occurred inside 40% of Indigenous houses (cf. 20% and 20% for non-Indigenous women, respectively; P < 0.001, 0.09).\ud \ud CONCLUSION: This small survey suggests that the prevalence of SIDS risk factors is higher in the Indigenous population, and a new approach to education is needed urgently to promote SIDS awareness among Indigenous women

Is being Aboriginal or Torres Strait Islander a risk factor for poor neonatal outcome in a tertiary referral unit in north Queensland?

OBJECTIVE: To compare perinatal outcomes for all births, and the morbidity and mortality patterns of babies admitted to neonatal intensive care, for non-Indigenous, Aboriginal and Torres Strait Islander (TSI) people in a major remote urban centre. METHODS: A prospective cohort study of all births and consecutive admissions to the Neonatal Intensive Care Unit/Special Baby Care Unit (NICU/SCBU) at Kirwan Hospital for Women (KWH), Townsville (a tertiary referral hospital) was conducted from January 1998 to June 1999. RESULTS: There were 2575 births, with 2392 (93%) booked into KWH for delivery. The Aboriginal group differed from the non-Indigenous group only in the prevalence of low-birthweight births. The TSI group had significantly higher perinatal mortality rates, preterm and low-birthweight births than the non-Indigenous group. Seven hundred and fifty-eight babies were admitted to NICU/SCBU: 586 (77%) non-Indigenous, 129 (17%) Aboriginal, 43 (6%) TSI. There were significantly more preterm, lower birthweight and longer stay length Aboriginal and TSI babies. Being Indigenous was not associated with neonatal death. Gestation of less than 28 weeks, congenital anomalies, and high-grade cerebral haemorrhage, but not ethnicity, were independent risk factors for neonatal death. Maternal risk factors, including poor antenatal care attendance, were more prevalent amongst Indigenous women. CONCLUSION: Neonatal outcomes for Aboriginal infants were better than expected from national and State reports. Outcomes for Torres Strait Islander infants were worse than expected. Ethnicity was not a risk factor for neonatal death. These findings suggest that outcomes may be further improved by programmes to increase access for Indigenous women to antenatal care services