ArticleJournal of epidemiology and community health2009
Primary birthing attendants and birth outcomes in remote Inuit communities--a natural "experiment" in Nunavik, Canada.
Article in Journal of epidemiology and community health, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 4 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Interventions to Address Disparities in Perinatal Outcomes by Ethnicity: A Systematic Review.BJOG : an international journal of obstetrics and gynaecology · 2025Pooled it
- Family-centred interventions for Indigenous early childhood well-being by primary healthcare services.The Cochrane database of systematic reviews · 2022Pooled it
- A review of health and wellness studies involving Inuit of Manitoba and Nunavut.International journal of circumpolar health · 2020Pooled it
- A decade of research in Inuit children, youth, and maternal health in Canada: areas of concentrations and scarcities.International journal of circumpolar health · 2012Pooled it
- Returning childbirth to inuit communities in the Canadian Arctic.International journal of circumpolar health · 2022Review
- Long-distance travel for birthing among Indigenous and non-Indigenous pregnant people in Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Article
- Article
- Is model of care associated with infant birth outcomes among vulnerable women? A scoping review of midwifery-led versus physician-led care.SSM - population health · 2016Article
- Rates of stillbirth by gestational age and cause in Inuit and First Nations populations in Quebec.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2013Article
- Birth outcomes and infant mortality among First Nations Inuit, and non-Indigenous women by northern versus southern residence, Quebec.Journal of epidemiology and community health · 2012Article
- Preterm birth in the Inuit and First Nations populations of Québec, Canada, 1981-2008.International journal of circumpolar health · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 8 institutions in 1 country.
Funding
Abstract
backgroundThere is a lack of data on the safety of midwife-led maternity care in remote or indigenous communities. In a de facto natural "experiment", birth outcomes were assessed by primary birthing attendant in two sets of remote Inuit communities.
methodsA geocoding-based retrospective birth cohort study in 14 Inuit communities of Nunavik, Canada, 1989-2000: primary birth attendants were Inuit midwives in the Hudson Bay (1529 Inuit births) vs western physicians in Ungava Bay communities (1197 Inuit births). The primary outcome was perinatal death. Secondary outcomes included stillbirth, neonatal death, post-neonatal death, preterm, small-for-gestational-age and low birthweight birth. Multilevel logistic regression was used to obtain the adjusted odds ratios (aOR) controlling for maternal age, marital status, parity, education, infant sex and plurality, community size and community-level random effects.
resultsThe aORs (95% confidence interval) for perinatal death comparing the Hudson Bay vs Ungava Bay communities were 1.29 (0.63 to 2.64) for all Inuit births and 1.13 (0.48 to 2.47) for Inuit births at > or =28 weeks of gestation. There were no statistically significant differences in the crude or adjusted risks of any of the outcomes examined.
conclusionRisks of perinatal death were somewhat but not significantly higher in the Hudson Bay communities with midwife-led maternity care compared with the Ungava Bay communities with physician-led maternity care. These findings are inconclusive, although the results excluding extremely preterm births are more reassuring concerning the safety of midwife-led maternity care in remote indigenous communities.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.