ArticleBMJ open2020
Socioethnic disparities in severe maternal morbidity in Western Australia: a statewide retrospective cohort study.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 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
- Racial inequities in severe maternal morbidity among Black and White people in Canada: a population-based cohort study, 2012 to 2023.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Article
- Historically informed quality improvement: applying historical insights from Black women's maternity care to contemporary health service redesign.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2026Article
- Maternal and neonatal health in Canada's Black communities: A scoping review of epidemiologic studies.Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- Supporting the implementation of a Maternal Early Warning System (MEWS) protocol using Human-Centred Design.BMC health services research · 2026Article
- Patient and contextual factors influence clinicians' decision making regarding universal screening for gestational diabetes: results of a factorial survey set in rural and remote Western Australia.BMC pregnancy and childbirth · 2025Article
- Geospatial Determinants of Maternal Overweight, Gestational Diabetes and Large for Gestational Age Birthweight in Melbourne During and After COVID-19 Lockdowns.The Australian & New Zealand journal of obstetrics & gynaecology · 2025Article
- Developing a research agenda for maternal health in the Top End of the Northern Territory of Australia: a participatory approach.BMC health services research · 2025Article
- Obstetric outcomes and uptake of care among 149 non-Swedish speaking migrant women attending a birth preparation visit during pregnancy - An observational study from Sweden.Journal of migration and health · 2024Article
- The Western Australian preterm birth prevention initiative: a whole of state singleton pregnancy cohort study showing the need to embrace alternative models of care for Aboriginal women.BMC pregnancy and childbirth · 2023Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the scale of ethnic inequalities in severe maternal morbidity (SMM) rates and quantify the contribution of maternal characteristics to these disparities.
designRetrospective cohort study.
settingWhole-of-population linked administrative data from 2002 to 2015 in Western Australia.
participantsWomen with 410 043 birth events (includes all births from the same pregnancy) of 20 weeks' or more gestation, including terminations for congenital anomalies. PRIMARY AND SECONDARY OUTCOME MEASURES: Women with SMM were identified based on a composite indicator of SMM using diagnosis and procedure codes developed for use in routinely collected data. Mothers were classified into seven ethnic groups, based on their reported ethnic origin. The associations between maternal ethnic origin and SMM were examined using a log-binomial model, which estimates risk ratios (RRs) and 95% CIs. The Blinder-Oaxaca decomposition technique was employed to partition the disparity in SMM between Aboriginal and Caucasian populations into 'explained' and 'unexplained' components.
resultsDuring the study period, 9378 SMM cases were documented. In the adjusted model, Aboriginal (RR 1.73, 95% CI 1.59 to 1.87), African (RR 1.64, 95% CI 1.43 to 1.89) and 'other' ethnicity (RR 1.49, 95% CI 1.37 to 1.63) women were at significantly higher risk of SMM compared with Caucasian women. Teenage and older mothers and socioeconomically disadvantaged women were also at greater risk of SMM. Differences in sociodemographic characteristics explained 33.2% of the disparity in SMM between Aboriginal and Caucasian women.
conclusionsThere are distinct disparities in SMM by ethnicity in Western Australia, with a greater risk among Aboriginal and African women. While improvements in SES and a reduction in teenage pregnancy can potentially support a sizeable reduction in SMM rate inequalities, future research should investigate other potential pathways and targeted interventions to close the ethnicity disparity.
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