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Open Access Study protocol

Wāhine hauora: linking local hospital and national health information datasets to explore maternal risk factors and obstetric outcomes of New Zealand Māori and non-Māori women in relation to infant respiratory admissions and timely immunisations

Sara Filoche1, Susan Garrett1, James Stanley2, Sally Rose1, Bridget Robson3, C Raina Elley4 and Bev Lawton1*

Author Affiliations

1 Women’s Health Research Centre, Dept of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand

2 Dean’s Department, University of Otago, Wellington, New Zealand

3 Te Rōpū Rangahau Hauora a Eru Pōmare, University of Otago, Wellington, New Zealand

4 School of Population Health, University of Auckland, University of Otago, Wellington, New Zealand

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BMC Pregnancy and Childbirth 2013, 13:145  doi:10.1186/1471-2393-13-145

Published: 10 July 2013

Abstract

Background

Significant health inequities exist around maternal and infant health for Māori, the indigenous people of New Zealand. The infants of Māori are more likely to die in their first year of life and also have higher rates of hospital admission for respiratory illnesses, with the greatest burden of morbidity being due to bronchiolitis in those under one year of age. Timely immunisations can prevent some respiratory related hospitalisations, although for Māori, the proportion of infants with age appropriate immunisations are lower than for non-Māori. This paper describes the protocol for a retrospective cohort study that linked local hospital and national health information datasets to explore maternal risk factors and obstetric outcomes in relation to respiratory admissions and timely immunisations for infants of Māori and non-Māori women.

Methods/Design

The study population included pregnant women who gave birth in hospital in one region of New Zealand between 1995 and 2009. Routinely collected local hospital data were linked via a unique identifier (National Health Index number) to national health information databases to assess rates of post-natal admissions and access to health services for Māori and non-Māori mothers and infants. The two primary outcomes for the study are: 1. The rates of respiratory hospitalisations of infants (≤ 1 yr of age) calculated for infants of both Māori and non-Māori women (for mothers under 20 years of age, and overall) accounting for relationship to parity, maternal age, socioeconomic deprivation index, maternal smoking status. 2. The proportion of infants with age appropriate immunisations at six and 12 months, calculated for both infants born to Māori women and infants born to non-Māori women, accounting for relationship to parity, maternal age, socioeconomic deprivation index, smoking status, and other risk factors.

Discussion

Analysis of a wide range of routinely collected health information in which maternal and infant data are linked will allow us to directly explore the relationship between key maternal factors and infant health, and provide a greater understanding of the causes of health inequalities that exist between the infants of Māori and non-Māori mothers.

Keywords:
Health disparities; Indigenous health; Routinely collected health data; Health information datasets; Maternity care; Infant health; Hospital admissions; Respiratory diseases; Immunisation