A Systematic Review of Child Health and Developmental Outcomes Associated with Low Birthweight and/or Small for Gestational Age in Indigenous Children from Australia, Canada and New Zealand

Abstract

While much is known about the health implications of low birthweight for infants and adults, there is limited information about the health implications in childhood, particularly for Indigenous children. The aim of this systematic review was to assess associations between low birthweight (LBW) and/or small for gestational age (SGA) and the developmental, physical or mental health outcomes for Australian, Canadian and New Zealand Indigenous children (5–12 years), including the potential mediating role of cultural connections. The review was guided by an Aboriginal Advisory Group established to guide the Aboriginal Families Study. Four databases were investigated with pre-determined inclusion/exclusion criteria. The search identified 417 articles after independent screening by two authors. Eight studies assessing six child outcomes were included. The review identified limited evidence, although the review suggested possible links between LBW and/or SGA and childhood asthma, lower body mass index (BMI) and poorer academic performance. Links between LBW, SGA and disability, global health and developmental vulnerability were inconclusive. One study identified cultural-based resilience as protective against perinatal adversity. In summary, research on the relationship between adverse birth outcomes and Indigenous children’s health and development is limited. Further investigation and collaboration with Indigenous communities is required to drive optimised health and social services responses and equitable system reform.

Reviewing Publicly Available Reports on Child Health Disparities in Indigenous and Remote Communities of Australia

“…Our review revealed that Indigenous Australians had a higher risk of adverse birth and child outcomes, including LBW, infant and child mortality and developmental vulnerability. Intergenerational trauma, socioeconomic disadvantages, limited medical care access and stressful life events may have also contributed to the higher level of adverse birth and child health outcomes [56]. A previously published study among Indigenous Western Australians documented that a large proportion of adverse birth outcomes were attributed to common modifiable risk factors such as smoking, alcohol or drug misuse and assault against the mother [57].…”

Mobile Health interventions for modifying indigenous maternal and child-health related behaviours: a systematic review (Preprint)

“…Adverse health outcomes including low birth weight, preterm birth, stillbirths, and perinatal mortality rates disproportionately affect indigenous families [3,4]. Indigenous women are more likely to experience domestic violence, have high levels of psychological distress and exhibit a higher prevalence of behavioural risk factors including tobacco, alcohol and other drug use in comparison with non-indigenous women [5][6][7]. Disparities between indigenous and non-indigenous maternal and child health outcomes highlight the need for urgent and specialised support [3].…”

A cross sectional study to identify factors determining low birth weight babies observed in a tribal district of Odisha, India

“…Therefore multifactorial relationship exists between the environment, health and nutritional status, social status of a woman and the growth of the fetus. All women, whether their pregnancies are complicated or not, need good quality maternal health services during pregnancy, delivery and in the post-partum period to ensure their health and that of their babies [6,7]. Risk cannot be totally eliminated once pregnancy has begun but they can be reduced through effective, affordable, accessible and acceptable maternity care [3].…”