Reem is a public health researcher and epidemiologist, with extensive experience in linked population health data management and analysis. Her doctoral research examined maternal and fetal outcomes of pregnant women with diabetes by method of birth, and she previously worked on data management and analysis of the National Perinatal Data Collection at the University of NSW, co-authoring three national reports. She is currently working on an NHMRC-funded project evaluating outcomes of the Connections program through an analysis of population linked health and justice datasets. This important initiative provides individualised support for post-release NSW prisoners with a history of problem drug use.
Can supervise: YES
Sullivan, E, Ward, S, Zeki, R, Wayland, S, Sherwood, J, Wang, A, Worner, F, Kendall, S, Brown, J & Chang, S 2019, 'Recidivism, health and social functioning following release to the community of NSW prisoners with problematic drug use: Study protocol of the population-based retrospective cohort study on the evaluation of the Connections Program', BMJ Open, vol. 9, no. 7.View/Download from: UTS OPUS or Publisher's site
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Introduction The rising rate of incarceration in Australia, driven by high reoffending, is a major public health problem. Problematic drug use is associated with increasing rates of reoffending and return to custody of individuals. Throughcare provides support to individuals during imprisonment through to post-release, improving both the transition to community and health outcomes post-incarceration. The aim of this study is to evaluate the Connections Programme (CP) that utilises a throughcare approach for release planning of people in prison with a history of problematic drug use. The study protocol is described. Methods and analysis Population-based retrospective cohort study. The study will use record linkage of the Connections dataset with 10 other New South Wales (NSW) population datasets on offending, health service utilisation, opioid substitution therapy, pregnancy, birth and mortality. The study includes all patients who were eligible to participate in the CP between January 2008 and December 2015 stratified by patients who were offered CP and eligible patients who were not offered the programme (non-CP (NCP)). Propensity-score matching will be used to appropriately adjust for the observable differences between CP and NCP. The differences between two groups will be examined using appropriate univariate and multivariate analyses. A generalised estimating equation approach, which can deal with repeat outcomes for individuals will be used to examine recidivism, mortality and other health outcomes, including perinatal and infant outcomes. Survival analysis techniques will be used to examine the effect of the CP by sex and Indigenous status on the â € time-To' health-related outcomes after adjusting for potential confounders. Ethics and dissemination Ethical approval was received from the NSW Population and Health Serv...
Sullivan, EA, Kendall, S, Chang, S, Baldry, E, Zeki, R, Gilles, M, Wilson, M, Butler, T, Levy, M, Wayland, S, Cullen, P, Jones, J & Sherwood, J 2019, 'Aboriginal mothers in prison in Australia: a study of social, emotional and physical wellbeing.', Australian and New Zealand journal of public health, vol. 43, no. 3, pp. 241-247.View/Download from: UTS OPUS or Publisher's site
OBJECTIVE:To describe the social, emotional and physical wellbeing of Aboriginal mothers in prison. METHODS:Cross-sectional survey, including a Short Form Health Survey (SF-12) and Kessler Psychological Distress Scale (5-item version) administered to Aboriginal women who self-identified as mothers. RESULTS:Seventy-seven Aboriginal mothers in New South Wales (NSW) and 84 in Western Australia (WA) participated in the study. Eighty-three per cent (n=59) of mothers in NSW were in prison for drug-related offences, 64.8% (n=46) of mothers in WA were in prison for offences committed under the influence of alcohol. Sixty-eight per cent (n=52) of mothers in NSW and 35% (n=28) of mothers in WA reported mental health problems. Physical (PCS) and Mental (MCS) component scores of SF-12 varied for mothers in NSW and WA. Mothers in NSW experienced poorer health and functioning than mothers in WA (NSW: PCS 49.5, MCS 40.6; WA: PCS 54.4, MCS 48.3) and high levels of psychological distress (NSW: 13.1; WA 10.1). CONCLUSIONS:Aboriginal mothers in prison have significant health needs associated with physical and mental health, and psychological distress. Implications for public health: Adoption of social and emotional wellbeing as an explanatory framework for culturally secure healthcare in prison is essential to improving health outcomes of Aboriginal mothers in prison in Australia.
Zeki, R, Li, Z, Wang, AY, Homer, CSE, Oats, JJN, Marshall, D & Sullivan, EA 2019, 'Obstetric anal sphincter injuries among women with gestational diabetes and women without gestational diabetes: A NSW population-based cohort study', Australian and New Zealand Journal of Obstetrics and Gynaecology.View/Download from: Publisher's site
© 2019 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists Background: Obstetric anal sphincter injuries (OASIs) are associated with maternal morbidity; however, it is uncertain whether gestational diabetes (GDM) is an independent risk factor when considering birthweight mode of birth and episiotomy. Aims: To compare rates of OASIs between women with GDM and women without GDM by mode of birth and birthweight. To investigate the association between episiotomy, mode of birth and the risk of OASIs. Methods: A population-based cohort study of women who gave birth vaginally in NSW, from 2007 to 2013. Rates of OASIs were compared between women with and without GDM, stratified by mode of birth, birthweight and a multi-categorical variable of mode of birth and episiotomy. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated by multivariable logistic regression. Results: The rate of OASIs was 3.6% (95% CI: 2.6–2.7) vs 2.6% (95% CI: 3.4–2.8; P < 0.001) among women with and without GDM, respectively. Women with GDM and a macrosomic baby (birthweight ≥ 4000 g) had a higher risk of OASIs with forceps (aOR 1.76, 95% CI: 1.08–2.86, P = 0.02) or vacuum (aOR 1.89, 95% CI: 1.17–3.04, P = 0.01), compared with those without GDM. For primiparous women with GDM and all women without GDM, an episiotomy with forceps was associated with lower odds of OASIs than forceps only (primiparous GDM, forceps-episiotomy aOR 2.49, 95% CI: 2.00–3.11, forceps aOR 5.30, 95% CI: 3.72–7.54), (primiparous without GDM, forceps-episiotomy aOR 2.71, 95% CI: 2.55–2.89, forceps aOR 5.95, 95% CI: 5.41–6.55) and (multiparous without GDM, forceps-episiotomy aOR 3.75, 95% CI: 3.12–4.50, forceps aOR 6.20, 95% CI: 4.96–7.74). Conclusion: Women with GDM and a macrosomic baby should be counselled about the increased risk of OASIs with both vacuum and forceps. With forceps birth, this risk can be partially mitigated by performing a concomitant episiotomy.
Zeki, R, Oats, JJN, Wang, AY, Li, Z, Homer, CSE & Sullivan, EA 2018, 'Cesarean section and diabetes during pregnancy: An NSW population study using the Robson classification.', The journal of obstetrics and gynaecology research, vol. 44, no. 5, pp. 890-898.View/Download from: UTS OPUS or Publisher's site
AIM:The aim of this study was to identify the main contributors to cesarean section (CS) among women with and without diabetes during pregnancy using the Robson classification and to compare CS rates within Robson groups. METHODS:A population-based cohort study was conducted of all women who gave birth in New South Wales, Australia, between 2002 and 2012. Women with pregestational diabetes (types 1 and 2) and gestational diabetes mellitus (GDM) were grouped using the Robson classification. Adjusted odd ratios (AOR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression. RESULTS:The total CS rate was 53.6% for women with pregestational diabetes, 36.8% for women with GDM and 28.5% for women without diabetes. Previous CS contributed the most to the total number of CS in all populations. For preterm birth, the contribution to the total was 20.5% for women with pregestational diabetes and 5.7% for women without diabetes. Compared to women without diabetes, for nulliparous with pregestational diabetes, the odds of CS was 1.4 (95% CI, 1.1-1.8) for spontaneous labor and 2.0 (95% CI, 1.7-2.3) for induction of labor. CONCLUSION:A history of CS was the main contributor to the total CS. Reducing primary CS is the first step to lowering the high rate of CS among women with diabetes. Nulliparous women were more likely to have CS if they had pregestational diabetes. This increase was also evident in all multiparous women giving birth. The high rate of preterm births and CS reflects the clinical issues for women with diabetes during pregnancy.
Zeki, R, Wang, AY, Lui, K, Li, Z, Oats, JJN, Homer, CSE & Sullivan, EA 2018, 'Neonatal outcomes of live-born term singletons in vertex presentation born to mothers with diabetes during pregnancy by mode of birth: a New South Wales population-based retrospective cohort study.', BMJ Paediatrics Open, vol. 2, no. 1, pp. e000224-e000224.View/Download from: UTS OPUS or Publisher's site
To investigate the association between the mode of birth and adverse neonatal outcomes of macrosomic (birth weight ≥4000 g) and non-macrosomic (birth weight <4000 g) live-born term singletons in vertex presentation (TSV) born to mothers with diabetes (pre-existing and gestational diabetes mellitus (GDM)).A population-based retrospective cohort study.New South Wales, Australia.All live-born TSV born to mothers with diabetes from 2002 to 2012.Comparison of neonatal outcomes by mode of birth (prelabour caesarean section (CS) and planned vaginal birth resulted in intrapartum CS, non-instrumental or instrumental vaginal birth).Five-minute Apgar score <7, admission to neonatal intensive care unit (NICU) or special care nursery (SCN) and the need for resuscitation.Among the 48 882 TSV born to mothers with diabetes, prelabour CS was associated with a significant increase in the rate of admission to NICU/SCN compared with planned vaginal birth.For TSV born to mothers with pre-existing diabetes, compared with non-instrumental vaginal birth, instrumental vaginal birth was associated with increased odds of the need for resuscitation in macrosomic (adjusted ORs (AOR) 2.6; 95% CI (1.2 to 7.5)) and non-macrosomic TSV (AOR 3.3; 95% CI (2.2 to 5.0)).For TSV born to mothers with GDM, intrapartum CS was associated with increased odds of the need for resuscitation compared with non-instrumental vaginal birth in non-macrosomic TSV (AOR 2.3; 95% CI (2.1 to 2.7)). Instrumental vaginal birth was associated with increased likelihood of requiring resuscitation compared with non-instrumental vaginal birth for both macrosomic (AOR 2.3; 95% CI (1.7 to 3.1)) and non-macrosomic (AOR 2.5; 95% CI (2.2 to 2.9)) TSV.Pregnant women with diabetes, particularly those with suspected fetal macrosomia, need to be aware of the increased likelihood of adverse neonatal outcomes following instrumental vaginal birth and intrapartum CS when planning mode of birth.
Li, Z, Zeki, R, Hilder, L & Sullivan, EA AIHW National Perinatal Epidemiology and Statistics Unit 2013, Australia's mothers and babies 2011, Perinatal statistics series no 4, no. Cat. no. PER 59., Canberra.