1. Objectifs

Intentions :
«[I]n the present study [the authors] sought to assess disparities in infant hospitalizations in First Nations, Inuit and non-Indigenous infants in Quebec, Canada. [They] also endeavoured to explore the factors that may explain these disparities.» (p. E739)

Questions/Hypothèses :
The authors «expect substantial disparities in Indigenous versus non-Indigenous infant hospitalizations in Canada.» (p. E739)

2. Méthode

Échantillon/Matériau :
In this study, the informations about «[p]regnancy complications and infant hospitalizations […] were based on hospital discharge records in the Maintenance et exploitation des données pour l’étude de la clientèle hospitalière database maintained at the Régie de l’assurance maladie du Québec (RAMQ). […] The linkage to hospitalization records was successful for 19 770 First Nations (97.9%), 3930 Inuit (92.3%) and 225 380 non-Indigenous (98.0%) infants. Therefore, the final study cohort comprised 249 080 infants.» (p. E741)

Type de traitement des données :
Analyse statistique

3. Résumé

The authors «found that First Nations and Inuit infants suffered a substantially elevated risk of hospitalization as a result of diseases of multiple systems. […]. The excess risks of these diseases may be related to infant immunization and the quality of the living environment, and thus may be largely preventable, suggesting the need to improve infant immunization programs, promote breastfeeding and no smoking in the child’s living environment, and improve living conditions in Indigenous communities.» (p. E743-E745) «The factors that may explain the excess risks of hospitalization in First Nations and Inuit infants are not yet fully understood. Maternal characteristics could partly explain these risk differences. Unmeasured risk factors, especially maternal smoking and alcohol use, may also contribute. […] Smoking and alcohol use may result in more unhealthy fetuses, contributing to elevated risks of multiple infant morbidities in First Nations and Inuit infants. Another unmeasured risk factor is the quality of perinatal care. […] Poor housing conditions, financial and food insecurity, and stress might [also] be contributing factors. Unexpectedly, pregnancy complications could not explain the excess infant hospitalizations in Indigenous populations. Although all major pregnancy complications were much more common in First Nations and Inuit women, the overall effects of adjusting for these pregnancy complications hardly diminished the hospitalization risk disparities between First Nations and Inuit versus non-Indigenous infants […].» (p. E745)