1. Objectifs

Intentions :
« It is unknown whether Aboriginal birth outcomes may be affected by the degree of community remoteness. [In this thesis], [w]e assessed community remoteness and birth outcomes among Quebec First Nations. » (p. 4)

Questions/Hypothèses:
« Little is know [sic] about the degree of community remoteness or isolation in relation to birth outcomes. Since poverty and lack of high-quality perinatal care services are often an socioeconomic reality in remote area, and that First Nations communities in more remote areas more likely face challenging health issues concerning birthing, neonatal and infant care, we hypothesis that birth outcome among First Nations may differ by the degree of community remoteness, where the less remote communities may have better birth outcomes compared to the more isolated communities, and the risk differences may be partly explained by maternal socioeconomic characteristics. » (p. 31)

2. Méthode

Échantillon/Matériau :
The author used « [...] Statistics Canada’s vital data for the province of Quebec, 1991-2000. » (p. 4)

Type de traitement des données:
Analyse statistique

3. Résumé

« RESULTS: Preterm birth rates rose progressively from the most remote (5.2%) to the least remote (8.2%) zone (P<0.001). In contrast, infant mortality rose progressively from the least remote (6.9/1000) to the most remote (16.8/1000) zone (P<0.01). The excess infant mortality in the more remote zones could be largely explained by the high postneonatal mortality. Postnatal SIDS [Sudden Infant Death Syndrome] was 3 times higher in the most remote compared to the least remote zone. Perinatal mortality was highest in the most remote zone but the differences were not significant across the four zones. Similar patterns were observed after adjusting for maternal age, education, parity and marital status. CONCLUSIONS: Despite lower rates of preterm deliveries, First Nations living in more remote communities suffered a substantially higher risk of infant death, especially postneonatal death, compared to First Nations living in less remote communities. There is a greater need for improving maternal and infant health in more remote Aboriginal communities. » (p. 4)