NSW Perinatal Data Collection (SAPHaRI). Centre for Epidemiology and Evidence, NSW Ministry of Health.
Any smoking in pregnancy is included.
Data include all mothers who gave birth (stillbirth or live birth) in NSW regardless of place of permanent residence.
The trend shows that in 2016, the percentage of all mothers and Aboriginal mothers smoking at all during pregnancy was the lowest it has been in 20 years at 8.3% of all mothers (declining from around 20% 20 years ago); and 41.3% of Aboriginal mothers (declining from just over 60% 20 years ago).
The NSW Perinatal Data Collection (PDC), formerly the NSW Midwives Data Collection (MDC), is a population-based surveillance system covering all births in NSW public and private hospitals, as well as homebirths. The PDC is a statutory data collection under the NSW Public Health Act 2010.
The PDC encompasses all live births, and stillbirths of at least 20 weeks gestation or at least 400 grams birth weight. Prior to 2006 the PDC encompassed all births of at least 20 weeks gestation or at least 400 grams birth weight. The data collection has operated since 1987 but with population coverage since 1990.
For every birth in NSW the attending midwife or medical practitioner completes a notification form (latest version for 2011: http://internal.health.nsw.gov.au/data/collections/mdc/NSWH%20Perinatal%20Data.pdf), or its electronic equivalent, giving demographic, medical and obstetric information on the mother and the condition of the infant. The PDC form was revised in 1998, 2006, 2011, and 2016.
There are several source systems that generate the PDC data. In 2016, 100% of PDC notifications were received electronically from public and private hospitals obstetric information systems. Electronically submitted records were received by secure upload to the state database. Historically, a proportion of records were received via completed paper forms that were submitted to the System Information and Analytics Branch of the NSW Ministry of Health, where they were compiled into the PDC database.
There are several electronic systems that generate the PDC data including ObstetriX, eMaternity, and Cerner in public hospitals and a variety of systems in private hospitals. ObstetriX is the most commonly used maternity information system in public hospitals in NSW.
Table 1. Perinatal Data Collection Notification Sources, NSW 2016
|Notification source||Local Health District or Hospital||
Per cent of PDC records 2016
All public hospitals in Northern Sydney, Central Coast, South Eastern Sydney, Illawarra Shoalhaven, Hunter New England, Nepean Blue Mountains and Western Sydney Local Health Districts. Some hospitals in Mid North Coast, Northern NSW, Murrumbidgee, Southern NSW, Western NSW and Far West Local Health Districts.
|Cerner||Sydney and South Western Sydney Local Health Districts.||18.5|
|Meditech||Ramsay Private Hospitals - North Shore Private Hospital, Westmead Private Hospital, St George Private Hospital, Kareena Private Hospital and Wollongong Private Hospital.||8.2|
|Sydney Adventist Obstetric Information System||Sydney Adventist Hospital||2.0|
|Healthscope||Healthscope hospitals - Prince of Wales Private Hospital, Norwest Private Hospital, Sydney South West Private Hospital, Nepean Private Hospital and Newcastle Private Hospital||8.3|
|The Mater Hospital database||The Mater Hospital, North Sudney||2.4|
|eMaternity||Mid North Coast, Northern NSW, Northern Sydney and Central Coast transitioned to eMaternity during 2016.||0.8|
The information sent to the NSW Ministry of Health is checked and compiled into one statewide dataset. One record is reported for each baby, even in the case of a multiple birth. The PDC includes notifications of births which occur in NSW which includes women whose usual place of residence is outside NSW and who give birth in NSW; it does not receive notifications of interstate births where the mother is resident in NSW. The collection is based on the date of birth of the baby. In 2016 there was an unusually large number of records with missing information that has resulted in a fluctuation in trends for analyses of subgroups.
Data are reported by calendar year. For this report, the PDC was accessed via SAPHaRI.
Any smoking in pregnancy is included in this indicator.
Up to 2010, the question asked at data collection was: Did you smoke at all during pregnancy? From 2011, there are two questions asked: Did you smoke at all during the first half of pregnancy? and: Did you smoke at all during the second half of pregnancy? The revised questions provide more opportunity for women to report their smoking history, and are likely to produce a more reliable measure of smoking rates in pregnancy than the original question.
The current data collection form for the NSW Perinatal Data Collection (PDC) commenced in 2016. Codes are described in the NSW Perinatal Data Collection Manual - 2016 Edition, which is available on the internet at http://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2015_025.pdf
In 2017 there were 95,825 births to 94,449 mothers in NSW, a decrease of 1.2% from 96,971 births in 2013. The percentage of multiple (twin and triplet) pregnancies has remained fairly stable over recent years at about 1.4%.
Between 2013 and 2017, the proportion of mothers who were teenagers continued to fall, from 3.0% to 2.0%; while the proportion of births to mothers over 35 years of age has remained stable.
Between 2012 and 2016:
• The proportion of mothers who smoked at all during pregnancy fell from 10.4% to 8.3%.
• The proportion of babies with low birth weight remained stable over the period, ranging from 6.1% to 6.6%.
• The proportion of preterm births was 7.3% of all births in 2016, a decrease from 7.6% in 2012.
• The perinatal mortality rate was 7.5 per 1,000 births in 2016, decreasing from 8.3 per 1,000 births in 2012.
• In 2016, there were 260 infant deaths in NSW, which was 2.7 deaths per 1,000 live births. The infant mortality rate in Australia was 3.1 deaths per 1,000 live births in 2016.
• Between 2013 and 2017, the number of reported births to Aboriginal or Torres Strait Islander mothers increased from 3,542 to 4,251, representing 3.7% and 4.4% respectively of all babies born in NSW.
•Between 2013 and 2017, the percentage of Aboriginal or Torres Strait Islander mothers who were teenagers fell substantially from 17.6% to 12.3%.
•Between 2012 and 2016, the percentage of Aboriginal or Torres Strait Islander mothers who commenced antenatal care before 14 weeks of pregnancy increased from 51.0% to 64.6%.
• The proportion of Aboriginal or Torres Strait Islander mothers smoking in pregnancy was 41.3% in 2016 compared with 49.9% in 2012.
• The perinatal mortality rate among babies born to Aboriginal or Torres Strait Islander mothers was 12.2 per 1,000 in 2016, higher than the rate of 7.3 per 1,000 for babies born to non-Aboriginal or Torres Strait Islander mothers.
The health of Australian mothers and babies is generally good by world standards. Maternal deaths are rare, and perinatal mortality rates are low.
The average woman in NSW can currently expect to give birth to 1.9 babies in her lifetime.
NSW mothers are getting older with the mean maternal age at first birth around 29 years and at subsequent birth just over 30. The proportion of teenage mothers is declining.
Aboriginal mothers and babies, those from socioeconomically disadvantaged areas, and some overseas-born mothers and their babies continue to experience worse outcomes than other NSW mothers and babies.
The NSW Ministry of Health maintains two population-based surveillance systems that collect information concerning pregnancy and birth: the NSW Perinatal Data Collection and the NSW Register of Congenital Conditions. They assist in monitoring the health of mothers and babies and, maternity service planning in NSW.
The implementation of the NSW Aboriginal Maternal and Infant Health Strategy has improved access to culturally appropriate maternity services for Aboriginal mothers.
The NSW Maternal and Perinatal Mortality Review Committee reviews each death of a mother or newborn baby to assess the cause and identify any possible avoidable factors. This information is used to improve services for mothers and babies.
NSW Ministry of Health at http://health.nsw.gov.au, in particular see the annual New South Wales Mothers and Babies report, published by the Centre for Epidemiology and Evidence. The latest edition is available at http://www.health.nsw.gov.au/hsnsw/Publications/mothers-and-babies-2016.pdf
Australian Bureau of Statistics at http://www.abs.gov.au, in particular see Births (ABS Cat no 3301.0)
Australian Institute of Health and Welfare at http://www.aihw.gov.au in general and in particular the AIHW's National Perinatal Statistics Unit and the annual publication: Australia’s mothers and babies.
healthdirect at http://www.healthdirect.gov.au
Population and Public Health Division. Improved reporting of Aboriginal and Torres Strait Islander peoples on population datasets in New South Wales using record linkage–a feasibility study. Sydney: NSW Ministry of Health, 2012. Available at: http://www.health.nsw.gov.au/hsnsw/Publications/atsi-data-linkage-report.pdf
Australian Council on Healthcare Standards. Obstetrics Indicator User Manual 2013. Obstetrics version 7.2. Sydney: ACHS, 2013. Available at: https://www.ranzcog.edu.au/component/docman/doc_view/267-obstetric-indicators.html?Itemid=946">
Data from the NSW Population Health Survey is used to measure the NSW State Government targets on reducing smoking in the population and is comparable with other sources of information on smoking in NSW.
• 15.2% of adults aged 16 years and over (18.1% of men and 12.3% of women) were current (daily or occasional) smokers, as estimated from the 2017 NSW Adult Population Health Survey (self-reported using Computer Assisted Telephone Interviewing or CATI).
• 15.4% of persons aged 15 years and over (18.8% of males and 12.1% of females) in NSW were current smokers (defined as daily, at least once a week or less than weekly), as estimated from the 2014-15 Australian Health Survey (interviewer-administered questionnaire).
• 8.3% of mothers smoked during pregnancy in 2016, as reported to the NSW Perinatal Data Collection.
• 6.7% of students aged 12-17 years (7.1% of boys and 6.3% of girls) were current smokers, as estimated from the 2014 NSW School Students Health Behaviours Survey (self-completed questionnaire).
• 28.5% of Aboriginal adults aged 16 years and over were current smokers as estimated from the 2017 NSW Adult Population Health Survey (self-reported using CATI).
• 41.3% of Aboriginal mothers smoked during pregnancy in 2016, as reported to the NSW Perinatal Data Collection.
Self-reported data on current smoking have been collected for adults in NSW since 1997 through the NSW Population Health Survey, since 1977-78 through the National Health Survey (from 1995), since 1985 through the National Drug Strategy Household Survey, and since 2011 through the Australian Health Survey.
Self-reported data on current smoking have been collected for students in NSW since 1984 through the NSW School Students Health Behaviours Survey.
Prevalence estimates, although differing slightly between surveys because of different sampling frames, participation rates and modes of collection (telephone, self-completed questionnaires, face-to-face personal interview and drop-and-collect) have all been decreasing over time.
A total of 47,196 hospitalisations were attributed to smoking in NSW in 2014-15, which was approximately 1.5% of all hospitalisations.
The rate of hospitalisations attributable to smoking decreased in males by almost 23% but remained stable in females in NSW between 2001-02 and 2014-15.
The rate of hospitalisations attributable to smoking increased in both Aboriginal males and Aboriginal females in the period between 2001-02 and 2011-12. In recent years, the rates have remained stable.
A total of 5,460 deaths were attributed to smoking in NSW in 2013, which was approximately 11% of all deaths in 2013.
The rate of death attributable to smoking has been declining in the decade up to 2013; the decline was much greater in males (about 32%) than in females (about 17%) but it occurred from a much higher base in males. In 2013, the rate of death attributable to smoking in males and females was 85.3 and 40.7 deaths per 100,000 population, respectively .
Centre for Epidemiology and Evidence, NSW Ministry of Health. NSW Population Health Surveys. Available at: http://www.health.nsw.gov.au/surveys/pages/default.aspx
Australian Institute of Health and Welfare. National Drug Strategy Household Survey report. Available at: http://www.aihw.gov.au/alcohol-and-other-drugs/data-sources/ndshs-2013/
Australian Bureau of Statistics. Australian Health Survey. Available at: http://www.abs.gov.au/australianhealthsurvey
Tobacco smoking is one of the biggest causes of premature death and is a leading preventable cause of chronic disease in New South Wales. It is a major risk factor for cardiovascular disease, a range of cancers, chronic obstructive pulmonary disease, coronary heart disease and a variety of other diseases and conditions. Approximately one in five of all cancer deaths are due to tobacco smoking.
There is a no safe level of exposure to second-hand tobacco smoke. In adults, breathing second-hand smoke can increase the risk of heart disease, lung cancer and other lung diseases. It can worsen the effects of existing illnesses such as asthma and bronchitis. For children, inhaling second-hand smoke is even more dangerous. Children are more likely to suffer health problems due to second-hand smoke such as bronchitis, pneumonia and asthma.
Australia has one of the most comprehensive tobacco control policies and programs in the world. The aim of the tobacco control programs in NSW is to contribute to a continuing reduction of smoking prevalence rates in the community.
Information on NSW Health tobacco and smoking control programs and policies is available at: http://www.health.nsw.gov.au/tobacco.
Cancer Institute at: https://www.cancerinstitute.org.au/
I Can Quit at http://www.icanquit.com.au
Information on NSW Health programs and policies is available at http://www.health.nsw.gov.au/tobacco.
Australian Bureau of Statistics at http://www.abs.gov.au
Australian Institute of Health and Welfare at http://www.aihw.gov.au
I Can Quit at http://www.icanquit.com.au