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Gaps in maternal health data identified

Australia lacks appropriate data to assess the impact of alcohol and substance abuse during pregnancy, new report finds. By Amber Forsyth.

Inadequate information on alcohol and substance abuse during pregnancy has been highlighted by an Australian Institute of Health and Welfare review on national maternity data.

Data on smoking during pregnancy was accessible nationally but other risk factors such as weight, and alcohol and substance abuse were not available.

“These data would help monitor trends and evaluate interventions to improve outcomes, such as low birthweight and some congenital anomalies,” said the report.

Improved data on the mental health and psychosocial wellbeing of mothers was also needed. Detailed information improved detection and treatment of postnatal depression, puerperal psychosis and other psychiatric conditions.

Approximately 800 babies are born every day in Australia. Data on pregnancy, labour, and birth, including mortality rates are some of the key indicators of health and wellbeing.

According to the report, the federal government has recognised the need for consistent, comprehensive and national maternity data in order to monitor progress for meeting UN Millennium Development Goals and Closing the Gap targets.

The review uncovered other key data gaps. In Australia, maternal deaths are rare. However, there was no nationally agreed method to report them. “Their monitoring is essential to ensure that any changes…do not adversely affect Australia’s low maternal mortality ratio,” the report said.

Inconsistencies in definitions, classification and reporting also impacted quality and availability of national data.

Agreed definitions, for example, were needed on models of care and common maternal conditions such as gestational diabetes and hypertension. They must consider local variations in service delivery and align with the Maternity Services Review models, said the report.

In response, the Perinatal National Minimum Data Set should include mandatory reporting on these data and other details such as previous pregnancies, antenatal visits and labour complications.

The Closing the Gap Initiative resulted in 2011 projects to add antenatal visits and maternal alcohol consumption to the national data collection.

The review found further irregularities in how states and territories shared and used information.

“At the national level, there are few links between data sets, and there is duplication of data collection,” the report said.

The review recommended the linking of birth registration, hospital and mortality data and further perinatal and birth collections.

New Zealand, Sweden, Scotland and the Netherlands were cited as using data linkage to ensure high quality maternity information systems.

New South Wales, South Australia and Western Australia have already shown some success in data linkage projects.

The report used both national and state and territory data collections on mothers and their babies from conception to 28 days after the birth.

Maternity data in Australia: a review of sources and gaps is available for download from Australian Institute of Health and Welfare web site, www.aihw.gov.au.

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