Canberra is the worst in its peer group for women smoking during pregnancy and had the second-highest infant and child death rates when compared with similar high-income metropolitan areas.
A National Health Performance Authority child and maternal health report released on Thursday reveals the ACT did not fare well in relation to smoking during pregnancy when compared with areas that are similar in socio-economic status, remoteness and distance to hospitals.
Canberra was placed in a peer group with Bayside in Victoria, Sydney north shore and beaches, eastern, northern and inner west Sydney as well as inner north-west and inner east Melbourne.
About one in 10 ACT women smoked during pregnancy - more than five times higher than Sydney's north shore and beaches where only 1.8 per cent of expectant mothers smoked. Nationally nearly 14 per cent of pregnant women smoked.
ACT Medicare Local chair Rashmi Sharma said the report was concerning.
"The beauty of these reports is that you're drilling the data down so you can actually see areas where you're not performing as well," Dr Sharma said.
"At the end of the day we want the smoking rate to be as low as possible and the infant mortality rate to be as low as possible."
An ACT Health spokeswoman said the ACT’s placement in its peer group was imprecise and the territory compared poorly as hidden disadvantage in the territory was not acknowledged.
"It is important to note that socio-economic disadvantage in the ACT is hidden by commonly used measures of socio-economic status," she said.
She said previous reporting on these topics was at the jurisdictional level, but the change to metro-level reporting was "no longer comparing like with like socio-economic status".
"Comparisons that do not reference this qualification may misrepresent the ACT position and should be treated with caution." she said.
Dr Sharma said although the ACT was doing well at reducing smoking rates generally, the data showed a stronger focus to prevent pregnant women smoking was needed.
Dr Sharma said smoking during pregnancy was associated with poorer outcomes for babies such as low birthweights and perinatal death, including sudden infant death syndrome.
The ACT Health spokeswoman said consultations around a project focusing on smoking in pregnancy were under way as was work on an Aboriginal and Torres Strait Islander Tobacco Control Strategy. She said there would also be research on smoking in pregnancy relating to Aboriginal and Torres Strait Islander women.
The data for 2009 to 2012 looked at 61 Medicare Local catchments, with each allocated to a peer group based on socio-economic status, remoteness and distance to hospitals. It found young children are up to three times more likely to die depending on where they live and the rate of low birthweight babies is more than double in some areas of Australia than others.
It is the first report from NPHA with a local breakdown of infant and young child mortality, low birth weight, smoking during pregnancy and access to antenatal care.
It showed the ACT's infant and child mortality rate was about 3.8 deaths per 1000 births - which was the next highest in the peer group after inner north-west Melbourne with 4.2 deaths per 1000 births.
About 20 children under five died annually on average in the ACT.
The Northern Territory had Australia's highest infant and young child death rates with 9.2 deaths per 1000 live births.
About 4.3 per cent of babies in the ACT were born with low birthweights, which was below the national figure of 4.8 per cent.
It was also the second highest in the peer group after inner north west Melbourne and the same as inner east Melbourne's figure. Of the 61 Medicare Local catchments, the ACT had ninth lowest percentage for low birth weights of the 61 Medicare Local catchments.
Low birthweight babies were at greater risk of poor health outcomes, including death and disability particularly in the first year of life, and had an increased risk in adulthood of type 2 diabetes, high blood pressure and cardiovascular disease, the report said.
The ACT Health spokeswoman said when compared withto national rates, the ACT’s infant mortality rates were consistently lower and rates for low birthweight babies were similar to the national rate.
Less than half, or 45.2 per cent, of pregnant women in the ACT received antenatal care in the first trimester - more than 20 percentage points below the national figure of 67.2 per cent.
The ACT health spokeswoman said a previous Australian Institute of Health and Welfare report had indicated most ACT children were "doing well against the majority of indicators".
The spokeswoman said in the ACT, first antenatal visits for pregnant mothers may not have been included in the hospital data collections. She said ACT Health had a number of programs for expectant parents and information was also available on ACT Health’s Women, Youth and Children’s webpage.
"The first trimester is an extremely important time because that's when the baby's organs are forming, it's when we do a lot of the scans to pick up conditions, it's a time to check your blood and all those preventive things that we can put in place including stopping smoking," Dr Sharma said.
She said the report was an opportunity to see where improvements to maternal and child healthcare in the ACT could be made.
NHPA chief executive Diane Watson said reporting at a local level identified areas where improvements in child and maternal health should be targeted.