Abstract

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Background

First Nations, Inuit, and Métis are at higher risk of adverse birth outcomes than are non-Indigenous people. However, relatively little perinatal information is available at the national level for Indigenous people overall or for specific identity groups.

Data and methods

This analysis describes and compares rates of preterm birth, small-for-gestational-age birth, large-for-gestational-age birth, stillbirth, and infant mortality (neonatal, postneonatal, and cause-specific) in a nationally representative sample of First Nations, Inuit, Métis, and non-Indigenous births. The study cohort consisted of 17,547 births to Indigenous mothers and 112,112 births to non-Indigenous mothers from 2004 through 2006. The cohort was created by linking the Canadian Live Birth, Infant Death and Stillbirth Database to the long form of the 2006 Census, which contains a self-reported Indigenous identifier.

Results

With the exception of small-for-gestational-age birth, adverse birth outcomes occurred more frequently among First Nations, Inuit, and Métis women than among non-Indigenous women. Inuit had the highest preterm birth rate (11.4 per 100 births; 95% CI: 9.7 to 13.1) among the three Indigenous groups. The large-for-gestational-age rate was highest for First Nations births (20.9 per 100 births; 95% CI: 19.9 to 21.8). Infant mortality rates were more than twice as high for each Indigenous group compared with the non-Indigenous population, and rates of sudden infant death syndrome were more than seven times higher among First Nations and Inuit.

Discussion

The results confirm disparities in birth outcomes between Indigenous and non-Indigenous populations, and demonstrate differences among First Nations, Métis and Inuit.

Keywords

Infant mortality, large-for-gestational-age birth, preterm birth, small-for-gestational-age birth, stillbirth

Findings

Birth outcomes among Indigenous peoples―First Nations, Inuit, and Métis―are consistently reported to be less favourable than among the non-Indigenous population.1 However, relatively little information is available at the national level for Indigenous people overall or for specific Indigenous identity groups, who have unique languages, customs, cultures, and colonial experiences. [Full Text]

Authors

Amanda J. Sheppard (Amanda.Sheppard@cancercare.on.ca) is with Cancer Care Ontario and the University of Toronto. Gabriel D. Shapiro, Jay S. Kaufman, Michael S. Kramer and Seungmi Yang are with McGill University. Tracey Bushnik is with the Health Analysis Division at Statistics Canada. Russell Wilkins is with the University of Ottawa. Serenity Perry is with the Ontario Native Women’s Association.

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