Does Living On-Reserve Versus Off-Reserve Make a Difference in First Nations Birth Outcomes in Manitoba, Canada?

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dc.contributor.authorHeaman, Maureen
dc.contributor.authorMartens, Patricia
dc.contributor.authorHart, Lyna
dc.contributor.authorSmylie, Janet
dc.contributor.authorAgnew, Elizabeth
dc.contributor.authorSimonet, Fabienne
dc.contributor.authorWassimi, Spogmai
dc.contributor.authorFraser, William D.
dc.contributor.authorLuo, Zhong-Cheng
dc.date.accessioned2018-01-05T17:47:18Z
dc.date.available2018-01-05T17:47:18Z
dc.date.issued2010-07-08
dc.description.abstractObjective: First Nations people in Canada often migrate between living “on-reserve” and “off-reserve.” The purpose of this study was to determine if there was any difference in birth outcomes among First Nations women living on-reserve versus off-reserve in Manitoba. Study Design: This population-based birth cohort study was conducted using Statistics Canada’s linked vital data for Manitoba, 1991-2000. A total of 26,176 First Nation births were identified (14,165 on-reserve, 12,011 off-reserve), based on self reporting by the mother or father. A mother was considered to be living on-reserve if her residential postal code (or municipal code) was among those used for First Nations bands or communities. Results: The crude rates of preterm (7.5% versus 9.7%) and small-for-gestational-age (7.3% versus 8.1%) births were significantly lower among First Nations women living on-reserve compared to off-reserve, while rates of neonatal death (4.1 versus 4.1 per 1,000) and postneonatal death (6.6 versus 5.6 per 1,000) were not significantly different. After adjusting for maternal characteristics and rural versus urban residence, the lower risks of preterm birth (adjusted odds ratio [aOR] 0.82 [95% confidence interval [CI] 0.75-0.90]) and small-for-gestational-age (aOR 0.89 [0.81-0.98]) on-reserve remained, but a higher risk of infant death was observed (aOR 1.29, 95% CI 1.00-1.67) mostly due to higher risk of postneonatal death. Conclusion: Living off-reserve is associated with higher rates of preterm and small-for-gestational-age births, suggesting the need to improve prenatal care. Living on-reserve is associated with higher rates of infant death, suggesting the need to improve infant care and socioeconomic conditions.en_US
dc.description.sponsorshipThis study was supported by a research grant from the Canadian Institutes of Health Research (CIHR), Institute of Aboriginal Peoples’ Health (IAPH) (grant # 73551)en_US
dc.identifier.citationHeaman, M., Marten, P., Hart, L., Smylie, J., Agnew, E., Simonet, F.,...Luo, Z. (2010). Does Living On-Reserve Versus Off-Reserve Make a Difference in First Nations Birth Outcomes in Manitoba, Canada? The Open Women’s Health Journal, 4, 39-45.en_US
dc.identifier.issn1874-2912
dc.identifier.urihttp://hdl.handle.net/1993/32739
dc.language.isoengen_US
dc.publisherBentham Openen_US
dc.rightsopen accessen_US
dc.subjectAboriginalen_US
dc.subjectNative Americanen_US
dc.subjectPregnancyen_US
dc.subjectBirth outcomesen_US
dc.subjectPreterm birthen_US
dc.subjectInfant deathen_US
dc.subjectIndigenousen_US
dc.titleDoes Living On-Reserve Versus Off-Reserve Make a Difference in First Nations Birth Outcomes in Manitoba, Canada?en_US
dc.typeArticleen_US
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