Indigenous Birth Outcomes in Australia, Canada, New Zealand and the United States - an Overview~!2010-01-14~!2010-04-16~!2010-07-06~!

Abstract

Objective-To review Indigenous infant mortality, stillbirth, birth weight, and preterm birth outcomes in Australia, Canada, New Zealand and the United States.Methods-Systematic searches of published literature and a review and assessment of existing perinatal surveillance systems were undertaken.Where possible, within country comparisons of Indigenous to non-Indigenous birth outcomes are included.Results-Indigenous/non-Indigenous infant mortality rate ratios range from 1.6 to 4.0.Stillbirth rates, where data are available, are also uniformly higher for Indigenous people.In all four countries, the disparities in Indigenous/non-Indigenous infant mortality rate ratios are most marked in the post-neonatal period.With few exceptions, the rates of leading causes of infant mortality are higher among Indigenous infants than non-Indigenous infants within all four countries.In most cases, rates of small for gestational age and preterm birth were also elevated for Indigenous compared to non-Indigenous infants.Conclusions-There are significant disparities in Indigenous/non-Indigenous birth outcomes in Australia, Canada, New Zealand and the United States.These Indigenous/non-Indigenous birth outcome disparities fit the criteria for health inequities, as they are not only unnecessary and avoidable, but also unfair and unjust.