https://nova.newcastle.edu.au/vital/access/ /manager/Index en-au 5 https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:54489 Wed 28 Feb 2024 16:31:52 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:45202 Streptococcus (GBS) and Escherichia coli (E. coli) have dominated as causes of EOS for five decades. Method: An 11-year retrospective cohort study to determine the epidemiology of EOS. Incidence rates were calculated per 1000 live births. Logistic regression with linear temporal trend and covariates for potential effect modifiers were employed. Blood culture utilisation was determined by examining the rate of babies undergoing blood culture within 72 hours of birth. Results: Among 93,584 live born babies, 65 had confirmed EOS (0.69/1000 live births); 22 term, 43 preterm. Across the 4 largest birth units, the proportion of babies having blood culture within 72 hours of birth varied from 1.9–5.1% for term and 21–35% for preterm babies. The annual change in the EOS rate was significant, OR 0.91 (95% CI, 0.84 to 0.99, p = 0.03). Group B Streptococcus was the most common cause of EOS in term neonates at 0.35/1000 live births (95% CI, 0.07–0.63) in 2006 and 0.1/1000 live births (95% CI, 0–0.2) in 2016. Escherichia coli was the most common cause in preterm babies at 3.4/1000 (95% CI, 0.11–6.76) in 2006 reducing significantly to 1.35/1000 live births (95% CI, -0.07–2.78) by 2016. Conclusions: Escherichia coli and GBS were the most common causes of EOS in preterm and term babies respectively. Rates of all cause term and preterm EOS declined significantly as did preterm sepsis due to E. coli. While rate of sepsis due to early-onset GBS declined, this did not reach significance. Given the high proportion of preterm babies undergoing blood culture, it is unlikely that any EOS events were missed.]]> Wed 26 Oct 2022 19:38:20 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:45197 Wed 26 Oct 2022 19:37:15 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:45111 2) test was used to identify if there was any association with maternal high-risk fertility behaviours and use of healthcare services. A multivariate logistic regression model was used to determine the effects of fertility behaviors and healthcare usage on the occurrence of U5M adjusting with confounders. Results: U5M declined from 82.5 to 41.0 per 1000 livebirths during 1994–2014 and is projected to further reduce to 17.6 per 1000 livebirths by 2030. The study identified a noticeable regional variation in U5M with maternal high-risk fertility behaviours including age at birth <18 years (aOR: 1.84, 95% CI: 1.23–2.76) and birth interval <24 months (aOR: 1.56, 95% CI: 1.02–2.37) found to be significant determinants. There was a 39–53% decline in this rate of mortality among women that had used antenatal care services at least four times (aOR, 0.51, 95% CI: 0.27–0.97), delivery care (aOR, 0.47, 95% CI: 0.24–0.95), and had received postnatal care (aOR, 0.61, 95% CI: 0.41–0.91) in their last birth. Cesarean section was found to be associated with a 51% reduction in U5M (aOR, 0.49, 95% CI: 0.29–0.82) compared to its non-use. Conclusion: The Sustainable Development Goals require a U5M rate of 25 per 1000 livebirths to be achieved by 2030. This study suggests that with the current trend of reduction, Bangladesh will achieve this target before the deadline. This study also found that maternal high-risk fertility behaviours and non-use of maternal healthcare services are very prevalent in some regions of Bangladesh and have increased the occurrence of U5M in those areas. This suggests therefore, that policies and programmes designed to reduce the pregnancy rates of women that are at risk and to encourage an increase in the use of maternal healthcare services are needed.]]> Wed 26 Oct 2022 12:45:21 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:52706 Wed 20 Mar 2024 14:49:32 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:53725 Wed 10 Jan 2024 11:23:54 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:38938 Wed 09 Mar 2022 15:58:36 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:38812 Wed 09 Feb 2022 16:45:30 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:37411 Wed 02 Mar 2022 14:26:42 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:37950 Thu 25 Nov 2021 12:29:58 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:53982 Thu 25 Jan 2024 12:57:08 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:37283 Thu 17 Sep 2020 15:29:22 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:37246 Thu 17 Mar 2022 14:36:54 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:37244 Thu 09 Dec 2021 11:03:26 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:40163 Thu 06 Jul 2023 10:57:56 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:48521 Mon 20 Mar 2023 17:28:23 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:44171 Mon 10 Oct 2022 10:06:42 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:40057 Mon 04 Jul 2022 15:12:41 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:37503 Fri 22 Jan 2021 14:53:20 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:36972 Fri 21 Oct 2022 14:58:01 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:53143 10 years and did not use an interpreter, had similar risk of term-LBW but 43% (aOR 1.43, 95% CI 1.14–1.78) higher risk of spontaneous PTB than the Australian-born women. Conclusion: Acculturation is an important factor to consider when providing antenatal care to prevent PTB and LBW in migrants. Acculturation may reduce the risk of term-LBW but, conversely, may increase the risk of spontaneous PTB in migrant women residing in Western Australia. However, the effect may vary by ethnicity and warrants further investigation to fully understand the processes involved.]]> Fri 17 Nov 2023 11:50:30 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:40090 N = 260,997) non-Indigenous births (2005–2013) were included. Logistic regression analysis was used to estimate odds ratios and 95% CI for AnteSB and IntraSB comparing migrant women from white, Asian, Indian, African, Māori, and ‘other’ ethnicities with Australian-born women controlling for risk factors and potential healthcare-related covariates. Of all the births, 66.1% were to Australian-born and 33.9% to migrant women. The mean age (years) was 29.5 among the Australian-born and 30.5 among the migrant mothers. For parity, 42.3% of Australian-born women, 58.2% of Indian women, and 29.3% of African women were nulliparous. Only 5.3% of Māori and 9.2% of African migrants had private health insurance in contrast to 43.1% of Australian-born women. Among Australian-born women, 14% had smoked in pregnancy whereas only 0.7% and 1.9% of migrants from Indian and African backgrounds, respectively, had smoked in pregnancy. The odds of AnteSB was elevated in African (odds ratio [OR] 2.22, 95% CI 1.48–2.13, P < 0.001), Indian (OR 1.64, 95% CI 1.13–2.44, P = 0.013), and other women (OR 1.46, 95% CI 1.07–1.97, P = 0.016) whereas IntraSB was higher in African (OR 5.24, 95% CI 3.22–8.54, P < 0.001) and ‘other’ women (OR 2.18, 95% CI 1.35–3.54, P = 0.002) compared with Australian-born women. When migrants were stratified by timing of first antenatal visit, the odds of AnteSB was exclusively increased in those who commenced ANC later than 14 weeks gestation in women from Indian (OR 2.16, 95% CI 1.18–3.95, P = 0.013), Māori (OR 3.03, 95% CI 1.43–6.45, P = 0.004), and ‘other’ (OR 2.19, 95% CI 1.34–3.58, P = 0.002) ethnicities. With midwife-only intrapartum care, the odds of IntraSB for viable births in African and ‘other’ migrants (combined) were more than 3 times that of Australian-born women (OR 3.43, 95% CI 1.28–9.19, P = 0.014); however, with multidisciplinary intrapartum care, the odds were similar to that of Australian-born group (OR 1.34, 95% CI 0.30–5.98, P = 0.695). Compared with Australian-born women, migrant women who utilised interpreter services had a lower risk of SB (OR 0.51, 95% CI 0.27–0.96, P = 0.035); those who did not utilise interpreters had a higher risk of SB (OR 1.20, 95% CI 1.07–1.35, P < 0.001). Covariates partially available in the data set comprised the main limitation of the study. Conclusion: Late commencement of ANC, underutilisation of interpreter services, and midwife-only intrapartum care are associated with increased risk of SB in migrant women. Education to improve early engagement with ANC, better uptake of interpreter services, and the provision of multidisciplinary-team intrapartum care to women specifically from African and ‘other’ backgrounds may reduce the risk of SB in migrants.]]> Fri 15 Jul 2022 09:57:23 AEST ]]>