Georgina M Chambers

Georgina M Chambers
UNSW Sydney | UNSW · National Perinatal Epidemiology and Statistics Unit at the Centre for Big Data Research in Health and School of Women's and Children's Health

PhD MBA BAppSci(MLS) GrdDp(IT)

About

123
Publications
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Publications

Publications (123)
Article
Full-text available
Spinal muscular atrophy (SMA) and severe combined immunodeficiency (SCID) are rare, inherited genetic disorders with severe mortality and morbidity. The benefits of early diagnosis and initiation of treatment are now increasingly recognized, with the most benefits in patients treated prior to symptom onset. The aim of the economic evaluation was to...
Article
Full-text available
Evidence on the cost-effectiveness of newborn screening (NBS) for severe combined immunodeficiency (SCID) in the Australian policy context is lacking. In this study, a pilot population-based screening program in Australia was used to model the cost-effectiveness of NBS for SCID from the government perspective. Markov cohort simulations were nested...
Article
Full-text available
Objective: To assess the association between maternal asthma and adverse perinatal outcomes in an Australian Indigenous population. Methods: This prospective cohort study included all Indigenous mother and baby dyads for births from 2001 to 2013 in Western Australia (n = 25 484). Data were linked from Western Australia Births, Deaths, Midwives,...
Article
The United Nations refers to South-South cooperation as a broad framework of collaboration between developing countries in the Global South. It can take place on a bilateral, regional, or interregional basis. Its main purpose is to share knowledge, skills, resources and successful initiatives to meet development goals through concerted partnerships...
Article
title International Committee for Monitoring Assisted Reproductive Technologies (ICMART) Preliminary World Report on ART, 2018 Study question In 2018 what was global utilization, effectiveness and safety of ART? Summary answer Globally, ART utilization and data collection continue to increase but with wide variations in utilization, effectiveness...
Article
Background From November 2019 to January 2020, eastern Australia experienced the worst bushfires in recorded history. Two months later, Sydney and surrounds were placed into lockdown for six weeks due to the COVID-19 pandemic, followed by ongoing restrictions. Many pregnant women at this time were exposed to both the bushfires and COVID-19 restrict...
Article
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Purpose The early postnatal period is a time of increased risk for psychiatric admission. However, there is scope to further examine if this increase in risk extends to the entire perinatal period (pregnancy and first postnatal year), and how it compares to admission outside of the perinatal period. Methods Data were linked across birth and hospit...
Article
STUDY QUESTION In a country with supportive funding for medically assisted reproduction (MAR) technologies, what is the proportion of MAR births over-time? SUMMARY ANSWER In 2017, 6.7% of births were conceived by MAR (4.8% ART and 1.9% ovulation induction (OI)/IUI) with a 55% increase in ART births and a stable contribution from OI/IUI births over...
Article
(Abstracted from Ultrasound Obstet Gynecol 2021;58:264–277) One of the risk factors for perinatal mortality and morbidity is abnormal fetal growth. The goal of this study was to study the prediction of adverse perinatal outcomes in preterm and term babies based on 3 birth weight (BW) standards (Australian population-based, Fenton, and INTERGROWTH-2...
Article
STUDY QUESTION What were the utilization, effectiveness and safety of practices in assisted reproductive technologies (ART) globally in 2014 and what global trends could be observed? SUMMARY ANSWER The estimated total number of ART cycles conducted in 76 participating countries in 2014 was 1.93 million representing ∼66% of global activity, with 5-...
Article
Full-text available
IntroductionAssisted reproductive technologies (ART), such as in-vitro fertilisation (IVF), have revolutionised the treatment of infertility, with an estimated 8 million babies born worldwide. However, the long-term health outcomes for women and their offspring remain an area of concern. Linking IVF treatment data to long-term health data is the mo...
Conference Paper
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Background Abnormal fetal growth is a risk factor for perinatal mortality and morbidity. There is considerable debate about the choice and performance of growth charts to classify newborns as small or large for gestational age (SGA and LGA) as a proxy for the at-risk infants. Several international charts have been proposed to be adopted worldwide....
Article
Objective: To evaluate three birthweight standards (Australian population-based, Fenton, and INTERGROWTH-21st ) and three estimated-fetal-weight [EFW] standards (Hadlock, INTERGROWTH-21st , and WHO) for classifying SGA, LGA, and predicting adverse perinatal outcomes in preterm and term babies METHODS: A nationwide population-based study was conduc...
Article
Background & aims: Between 2014-2019, the SToP-C trial observed a halving in HCV incidence in four Australian prisons following scale-up of direct-acting antiviral (DAA) therapy. However, the contribution of HCV treatment to this decline is unclear due to the study not having a control group. We used modelling to consider this question. Approach...
Article
Problem Although perinatal universal depression and psychosocial assessment is recommended in Australia, its clinical performance and cost-effectiveness remain uncertain. Aim To compare the performance and cost-effectiveness of two models of psychosocial assessment: Usual-Care and Perinatal Integrated Psychosocial Assessment (PIPA). Methods Women...
Article
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Objectives The aim of this study is to quantify societal preferences for, and assess trade-offs between characteristics of treatment programmes for impulsive-violent offenders. Setting The study was conducted in New South Wales, Australia’s largest state. Participants The study participants were income tax payers, aged over 18 and who were able t...
Article
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Background: Limited empirical evidence exists for the effectiveness of hepatitis C virus (HCV) treatment-as-prevention. The Surveillance and Treatment of Prisoners with hepatitis C (SToP-C) study aimed to assess the effect of HCV treatment-as-prevention in the prison setting. Methods: SToP-C was a prospective study, including a before-and-after...
Article
Objectives To systematically review studies eliciting monetary value of a statistical life (VSL) estimates within, and across, different sectors and other contexts; compare the reported estimates; and critically review the elicitation methods used. Methods In June 2019, we searched the following databases to identify methodological and empirical s...
Article
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Background: With direct-acting antivirals dramatically reshaping the public health response to the hepatitis C virus (HCV), prisons are set to play a critical role in elimination efforts. Despite the theoretical demonstration of HCV treatment-as-prevention in prison in mathematical modeling, limited empirical data exist. The Australian 'Surveillan...
Article
Objective To report the utilization, effectiveness, and safety of practices in assisted reproductive technology (ART) globally in 2013 and assess global trends over time. Design Retrospective, cross-sectional survey on the utilization, effectiveness, and safety of ART procedures performed globally during 2013. Setting Seventy-five countries and 2...
Article
Full-text available
In Australian prisons approximately 20% of inmates are chronically infected with hepatitis C virus (HCV), providing an important population for targeted treatment and prevention. A dynamic mathematical model of HCV transmission was used to assess the impact of increasing direct-acting antiviral (DAA) treatment uptake on HCV incidence and prevalence...
Article
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Background Despite advances in the care of women and their babies in the past century, an estimated 1.7 million babies are born still each year throughout the world. A robust method to estimate a pregnant woman’s individualized risk of late-pregnancy stillbirth is needed to inform decision-making around the timing of birth to reduce the risk of sti...
Article
The health of children born through assisted reproductive technologies (ART) is particularly vulnerable to policy decisions and market forces that play out before they are even conceived. ART treatment is costly, and public and third-party funding varies significantly between and within countries, leading to considerable variation in consumer affor...
Article
Study question: What was the utilization, effectiveness and safety of practices in ART globally in 2012 and what global trends could be observed? Summary answer: The total number of ART cycles increased by almost 20% since 2011 and the main trends were an increase in frozen embryo transfers (FET), oocyte donation, preimplantation genetic testing...
Article
Full-text available
Objectives To prepare more accurate population‐based Australian birthweight centile charts by using the most recent population data available and by excluding pre‐term deliveries by obstetric intervention of small for gestational age babies. Design Population‐based retrospective observational study. Setting Australian Institute of Health and Welf...
Article
Objective To quantify the economic and health-related quality of life (HRQoL) burden incurred by households with a child affected by spinal muscular atrophy (SMA). Methods Hospital records, insurance claims, and detailed resource use questionnaires completed by caregivers were used to capture the direct and indirect costs to households of 40 child...
Article
Study question: What are the success rates for women returning to ART treatment in the hope of having a second ART-conceived child. Summary answer: The cumulative live birth rate (LBR) for women returning to ART treatment was between 50.5% and 88.1% after six cycles depending on whether women commenced with a previously frozen embryo or a new ov...
Preprint
Full-text available
Background Despite advances in the care of women and their babies in the past century, an estimated 1.7 million babies are born still each year throughout the world. A robust method to estimate a pregnant woman’s individualized risk of late-pregnancy stillbirth is needed to inform decision-making around timing of birth to reduce the risk of stillbi...
Preprint
Full-text available
Background: Despite advances in the care of women and their babies in the past century, an estimated 1.7 million babies are born still each year throughout the world. A robust method to estimate a pregnant woman’s individualized risk of late-pregnancy stillbirth may inform decision-making around timing of birth to reduce the risk of stillbirth from...
Preprint
Full-text available
Background: Despite advances in the care of women and their babies in the past century, an estimated 1.7 million babies are born still each year throughout the world. A robust method to estimate a pregnant woman’s individualized risk of late-pregnancy stillbirth is needed to inform decision-making around timing of birth to reduce the risk of stillb...
Article
This commentary outlines the importance of utilization of assisted reproductive technology as an indicator of access to infertility care and provides a standard way of reporting utilization to facilitate international comparisons. Factors that influence ART utilization as well as underlying inequalities and inequities in access to care are discusse...
Article
Study question: How did general practitioners (GPs) (family physicians) manage infertility in females and males in primary care between 2000 and 2016? Summary answer: The number of GP infertility consultations for females increased 1.6 folds during the study period, with 42.9% of consultations resulting in a referral to a fertility clinic or spe...
Article
This study estimates the future utilization of medically assisted fertility treatments in Australia, focusing on assisted reproductive technologies (ARTs), intrauterine insemination (IUI), and ovulation induction. A multistate cohort component population projection model is used to determine future fertility rates from 2016 to 2026 by age and educa...
Article
Background: Maternity populations are becoming increasingly multiethnic. Conflicting findings exist regarding the risk of adverse perinatal outcomes among immigrant mothers from different world regions and which growth charts are most appropriate for identifying the risk of adverse outcomes. Objective: To evaluate whether infant mortality and mo...
Book
For over forty years, assisted reproductive technology (ART) has helped millions of patients around the world to overcome infertility. Careful monitoring of ART treatments and their outcomes is vital to maintain the remarkable pace of change in science and technology, whilst minimizing potential risks to infertility patients, and their children. Wr...
Article
Background Discrete-Choice Experiments (DCEs) are used to assess the strength of preferences and value of interventions, but researchers using the method have been criticised for failing to either undertake or publish the rigorous research for selecting the necessary attributes and levels. The aim of this study was to elicit attributes to inform a...
Article
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This paper helps to quantify the impact of the Australian National Perinatal Depression Initiative (NPDI) on postnatal inpatient psychiatric hospitalisation. Based on individual hospital admissions data from New South Wales and Western Australia, we found that the NPDI reduced inpatient psychiatric hospital admission by up to 50% [0.9% point reduct...
Article
Background: Current evidence suggests that preimplantation genetic testing for aneuploidy (PGT-A) used during assisted reproductive technology improves per-cycle live-birth rates but cumulative live-birth rate (CLBR) was similar to a strategy of morphological assessment (MA) of embryos. No study has assessed the cost-effectiveness of repeated cycl...
Article
Full-text available
Introduction: The increasing burden that offenders place on justice and health budgets necessitates better methods to determine the benefits of and value society places on offender programmes to guide policy regarding resource allocation. The aim of this paper is to demonstrate how economic methods will be used to determine the strength of prefere...
Article
Full-text available
Background Data on burden of severe influenza in children with a range of chronic lung diseases (CLDs) remain limited. Method We performed a cohort study to estimate burden of influenza‐associated hospitalization in children with CLDs using population‐based linked data. The cohort comprised all children in New South Wales, Australia, born between...
Article
Full-text available
Objective: To investigate preferences for fertility treatment from the Australian general population with the aims of calculating the willingness to pay in tax contribution for attributes (characteristics) that make up treatment and for an 'ideal' fertility treatment program. We also assessed whether willingness to pay varies by the relationship s...
Article
Objective To report the utilization, effectiveness, and safety of practices in assisted reproductive technology (ART) globally in 2011 and assess global trends over time. Design Retrospective, cross-sectional survey on the utilization, effectiveness, and safety of ART procedures performed globally during 2011. Setting Sixty-five countries and 2,5...
Article
Background Stillbirth remains a public health concern in high‐income countries. Over the past 20 years, stillbirth rates globally have shown little improvement and large disparities. The overall stillbirth rate, which measures risk among births at all gestations, masks diverging trends at different gestations. This study investigates trends over ti...
Article
Background The contingent valuation (CV) method is an alternative approach to typical health economic methods for valuing interventions that have both health and non-health outcomes. Fertility treatment, such as in vitro fertilisation (IVF), fall into this category because of the significant non-health outcomes associated with having children. Aim...
Article
Social capital has been associated with improved health outcomes. Measures of social capital have been developed specifically for different population groups, cultures, and contexts; however, there is no readily available measure for use among inmates in the prison setting. This study sought to translate a community concept into the prison setting...
Article
Background: The Maternity Care Classification System is a novel system developed in Australia to classify models of maternity care based on their characteristics. It will enable large-scale evaluations of maternal and perinatal outcomes under different models of care independently of the model's name. Aim: To assess the accuracy, repeatability a...
Article
Full-text available
Introduction In Australia, societal and individual preferences for funding fertility treatment remain largely unknown. This has resulted in a lack of evidence about willingness to pay (WTP) for fertility treatment by either the general population (the funders) or infertile individuals (who directly benefit). Using a stated preference discrete choic...
Article
Background: Preimplantation genetic diagnosis for aneuploidy (PGD-A) for all 24 chromosomes improves implantation and clinical pregnancy rates per single assisted reproductive technology (ART) cycle. However, there is limited data on the live-birth rate of PGD-A over repeated cycles. Aim: To assess the cumulative live-birth rates (CLBR) of PGD-A...
Article
Objective To quantify total provider fees, benefits paid by the Australian Government and out-of-pocket patients' costs of mental health Medicare Benefits Schedule (MBS) consultations provided to women in the perinatal period (pregnancy to end of the first postnatal year).Method A retrospective study of MBS utilisation and costs (in 2011-12 A$) for...
Article
Objectives: To estimate cumulative live birth rates (CLBRs) following repeated assisted reproductive technology (ART) ovarian stimulation cycles, including all fresh and frozen/thaw embryo transfers (complete cycles). Design, setting and participants: Prospective follow-up of 56 652 women commencing ART in Australian and New Zealand during 2009-...
Article
Public expenditure on the criminal justice system represents a significant fiscal burden to government worldwide, making the economic evaluation of interventions aimed at improving justice outcomes critical to informing resource allocation. This study systematically reviews and assesses the scope and quality of economic evaluations of behavioral in...
Article
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Background Studies examining psychosocial and depression assessment programs in maternity settings have not adequately considered the context in which psychosocial assessment occurs or how broader components of integrated care, including clinician decision-making aids, may optimise program delivery and its cost-effectiveness. There is also limited...
Article
Background: Without a standard terminology to classify models of maternity care, it is problematic to compare and evaluate clinical outcomes across different models. The Maternity Care Classification System is a novel system developed in Australia to classify models of maternity care based on their characteristics and an overarching broad model des...
Article
Prisoner populations are characterized by high rates of hepatitis C (HCV), up to thirty times that of the general population in Australia. Within Australian prisons, less than 1% of eligible inmates access treatment. Public health strategies informed by social capital could be important in addressing this inequality in access to HCV treatment. Twen...
Research
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This report presents an analysis of the statistics for stillbirths and neonatal deaths in Australia for the calendar years 2011 and 2012, as well as selected trend information for 1993–2012. The aim of this report is to gain a better understanding of the characteristics and causes of stillbirths and neonatal deaths in Australia at a population leve...
Conference Paper
The Maternity Care Classification System: a more accurate way of defining models of care than by name alone Natasha Donnolley, Georgina Chambers, Michael Chapman, Kerryn Butler-Henderson, Elizabeth Sullivan. Background There is well-established evidence that outcomes for low-risk women and their babies are better in some models of maternity care co...
Article
STUDY QUESTION Have ART live birth rates improved in Australia over the last 12 years? SUMMARY ANSWER There were striking improvements in per-cycle live birth rates observed for frozen/thaw embryo transfers, blastocyst transfer and single embryo transfer (SET), while live birth rates following ICSI were lower than IVF for non-male factor infertili...
Article
Full-text available
Background Social capital has been shown to be a valuable resource for improving health outcomes. However, it has received little attention in the prison setting. Dimensions of social capital in mainstream society are likely to function differently among inmates in prison. This study seeks to identify and understand social capital dimensions among...
Article
Women from disadvantaged socio-economic groups access assisted reproductive technology treatment less than women from more advantaged groups. However, women from disadvantaged groups tend to start families younger, making them less likely to suffer from age-related subfertility and potentially have less need for fertility treatment. Whether socio-e...
Article
Social capital is a valuable resource that has received little attention in the prison context. Differences in the construct and accessibility of bonding, bridging, and linking social capital exist for Aboriginal Australians in mainstream society, but were previously unexplored in prison. This study seeks to understand contextual differences of soc...
Article
Study question: What were utilization, outcomes and practices in assisted reproductive technology (ART) globally in 2008, 2009 and 2010? Summary answer: Global utilization and effectiveness remained relatively constant despite marked variations among countries, while the rate of single and frozen embryo transfers (FETs) increased with a concomit...
Article
Full-text available
Objective: Faecal elastase-1 (FE1) is a sensitive marker for exocrine pancreatic enzyme insufficiency. Pancreatic insufficiency (EPI) leads to maldigestion and subsequent poor weight gain. Thus, FE1 is performed as work-up for children with failure to thrive (FTT). However, EPI in the paediatric population outside of cystic fibrosis (CF) is rare....
Article
Full-text available
Linked administrative population data were used to estimate the burden of childhood respiratory syncytial virus (RSV) hospitalization in an Australian cohort aged <5 years. RSV-coded hospitalizations data were extracted for all children aged <5 years born in New South Wales (NSW), Australia between 2001 and 2010. Incidence was calculated as the tot...