Closing the gap in reproductive health for Aboriginal and Torres Strait Islander women: lessons learned from longitudinal perinatal cohort studies.

Abstract

Longitudinal, Indigenous-led research integrated with community-controlled continuity of care can improve and support perinatal outcomes for Aboriginal and Torres Strait Islander families in Australia. Across the past 35 years, seven cohorts have contributed complementary insights from pregnancy through early childhood with varying geographic reach and appropriate Indigenous governance. This paper discusses each of these cohorts and how these studies across pregnancy, birth and some continuing through early childhood, have substantially added to the body of knowledge related to perinatal health needs for women. Early cohorts (e.g., MUSP; Raine) advanced life‑course epidemiology but had low Indigenous representation, limiting perinatal inference for these communities. The Aboriginal Birth Cohort achieved exceptional long‑term retention and partnerships and from the late 2000s, Gomeroi gaaynggal enabled causation analyses using biomarkers. Finally, systems initiatives such as PANDORA and BiOC demonstrate successes with culturally safe pathways and Indigenous‑governed continuity models. Evidence suggests the approaches undertaken in the perinatal period must ensure the voices of Indigenous people are paramount particularly when care and research is being delivered to communities. Lessons learned from these cohorts highlight that Indigenous governance and workforce, co‑design and community‑embedded engagement enhance retention, relevance and translation; registries and continuity models deliver measurable outcome gains. The depth of knowledge identified in life-course research for Indigenous women can significantly add to the standard data collection tools used by state and national services.