1. Macrosomia, Perinatal and Infant Mortality in Cree Communities in Quebec, 1996-2010
- Author
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Nancy Gros-Louis McHugh, Dan-Li Zhang, Lin Xiao, Jill Torrie, Zhong-Cheng Luo, and Nathalie Auger
- Subjects
Male ,Physiology ,Maternal Health ,lcsh:Medicine ,Geographical locations ,Fetal Macrosomia ,Cohort Studies ,Families ,0302 clinical medicine ,Infant Mortality ,Medicine and Health Sciences ,Ethnicity ,Medicine ,Birth Weight ,030212 general & internal medicine ,Young adult ,lcsh:Science ,Children ,education.field_of_study ,Multidisciplinary ,Quebec ,Gestational age ,Obstetrics and Gynecology ,3. Good health ,Physiological Parameters ,Research Design ,Marital status ,Female ,0305 other medical science ,Infants ,Stillbirths ,Cohort study ,Research Article ,Adult ,Canada ,Death Rates ,Birth weight ,Population ,Research and Analysis Methods ,03 medical and health sciences ,Young Adult ,Population Metrics ,Humans ,education ,Demography ,Retrospective Studies ,030505 public health ,Population Biology ,business.industry ,lcsh:R ,Body Weight ,Biology and Life Sciences ,Neonates ,Infant ,Retrospective cohort study ,Infant mortality ,Age Groups ,People and Places ,North America ,Birth ,Women's Health ,lcsh:Q ,Population Groupings ,business ,Developmental Biology - Abstract
Background Cree births in Quebec are characterized by the highest reported prevalence of macrosomia (~35%) in the world. It is unclear whether Cree births are at greater elevated risk of perinatal and infant mortality than other First Nations relative to non-Aboriginal births in Quebec, and if macrosomia may be related. Methods This was a population-based retrospective birth cohort study using the linked birth-infant death database for singleton births to mothers from Cree (n = 5,340), other First Nations (n = 10,810) and non-Aboriginal (n = 229,960) communities in Quebec, 1996-2010. Community type was ascertained by residential postal code and municipality name. The primary outcomes were perinatal and infant mortality. Results Macrosomia (birth weight for gestational age >90th percentile) was substantially more frequent in Cree (38.0%) and other First Nations (21.9%) vs non-Aboriginal (9.4%) communities. Comparing Cree and other First Nations vs non-Aboriginal communities, perinatal mortality rates were 1.52 (95% confidence intervals 1.17, 1.98) and 1.34 (1.10, 1.64) times higher, and infant mortality rates 2.27 (1.71, 3.02) and 1.49 (1.16, 1.91) times higher, respectively. The risk elevations in perinatal and infant death in Cree communities attenuated after adjusting for maternal characteristics (age, education, marital status, parity), but became greater after further adjustment for birth weight (small, appropriate, or large for gestational age). Conclusions Cree communities had greater risk elevations in perinatal and infant mortality than other First Nations relative to non-Aboriginal communities in Quebec. High prevalence of macrosomia did not explain the elevated risk of perinatal and infant mortality in Cree communities.
- Published
- 2016