Abstract
Background: Significant health inequities exist around maternal and infant health for Maori, the indigenous people of New Zealand. The infants of Maori 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 Maori, the proportion of infants with age appropriate immunisations are lower than for non-Maori. 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 Maori and non-Maori 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 Maori and non-Maori 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 Maori and non-Maori 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 Maori women and infants born to non-Maori 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 Maori and non-Maori mothers.