Obstetric, child health outcomes, trends and readmissions for term women birthing in South-West Sydney (2001–2016): a linked data population-based study

Objective: The aim of this study was to explore obstetric outcomes and postpartum readmissions of women and infants in an area in NSW, serving women who are from lower socio-economic and culturally diverse backgrounds. Methods: A linked data population-based study was conducted of women living in South-West Sydney Local Health District. Registry data on women giving birth to singleton infants between 37 + 0–41 + 6 weeks gestation, between January 1st 2001-December 31st 2016, was utilised and analysed. Results: In total data of 130 533 singleton term pregnancies were analysed with rates differing by health status as follows: healthy (11.6%), maternal diabetes (8.3%), hypertensive disease (10.1%), maternal diabetes and hypertensive disease (8.2%), psychological disorders/diseases (40.5%), or psychological diseases with either diabetes or hypertension (28.1%). When compared to women with healthy pregnancies, women with complex pregnancies were more likely to have an induction of labour, epidural anaesthesia, caesarean section, early term births and poor foetal growth, and infants had higher rates of asphyxiation and need for major resuscitation. Postnatally, women with complex pregnancies and their infants were more frequently readmitted to the hospital in the year following birth, both in the short- and longer-term. Additionally, the change in glucose cut-offs in 2014 led to a significant increase in gestational diabetes diagnosis. Conclusion: Overall, women with complicated pregnancies in the South-West Sydney Local Health District faced significantly more adverse obstetric and child outcomes, with increased hospital readmissions within the first year postpartum.