Development and Validation of an Algorithm to Determine Spontaneous versus Provider‐Initiated Preterm Birth in <scp>US</scp> Vital Records

Klebanoff, Mark A.; Yossef-Salameh, Lina; Latimer, C.; Oza-Frank, Reena; Kachoria, Rashmi; Reagan, Patricia B.; Oliver, Emily A.; Buhimschi, Catalin S.; Buhimschi, Irina A.

doi:10.1111/ppe.12267

Cited by 30 publications

(31 citation statements)

References 26 publications

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“…We approached the categorisation of this variable from a clinically minded standpoint and thus did not include stillbirths or those born below the limit of viability. Using a validated algorithm developed for use with US vital records, we stratified preterm births by type, categorising them as spontaneous (preceded by spontaneous membrane rupture and/or uterine contractions) or clinician‐initiated (labour or delivery occurred secondary to medical intervention) . The kappa statistic for the algorithm is 0.83 (0.70, 0.95), indicating excellent agreement between algorithm‐assigned and manually assigned preterm birth type…”

Section: Methodsmentioning

confidence: 99%

Risks of preterm birth among non‐Hispanic black and non‐Hispanic white women: Effect modification by maternal age

Keiser

Salinas

DeWan

et al. 2019

Paediatric Perinatal Epid

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Background Preterm birth (PTB) disproportionately affects African American compared with Caucasian women, although reasons for this disparity remain unclear. Some suggest that a differential effect of maternal age by race/ethnicity, especially at older maternal ages, may explain disparities. Objective To determine whether the relationship between maternal age and preterm birth varies by race/ethnicity among primiparae non‐Hispanic blacks (NHB) and non‐Hispanic whites (NHW). Methods A cross‐sectional study of 367 081 singleton liveborn first births to NHB and NHW women in California from 2008 to 2012 was conducted. Rate ratios (RR) were estimated for PTB and its subtypes—spontaneous and clinician‐initiated—after adjusting for confounders through Poisson regression. Universal age/race reference groups (NHW, 25‐29 years) and race‐specific reference groups (NHW or NHB, 25‐29 years) were used for comparisons. Results Among all women, RR of PTB was highest at the extremes of age (<15 and ≥40 years). Among NHBs, the risk of PTB was higher than among NHWs at all maternal ages (adjusted RR of PTB 1.38‐2.93 vs 0.98‐2.38). However, using race‐specific reference groups, the risk of PTB for NHB women (RR 0.91‐1.88) vs NHW women (RR 0.98‐2.39) was nearly identical at all maternal ages, with overlapping confidence intervals. Analyses did not demonstrate substantial divergence of risk with advancing maternal age. PTB, spontaneous PTB, and clinician‐initiated PTB demonstrated similar risk patterns at younger but not older maternal ages, where risk of clinician‐initiated PTB increased sharply for all women. Conclusions Primiparae NHBs demonstrated increased risk of PTB, spontaneous PTB, and clinician‐initiated PTB compared with NHWs at all maternal ages. However, RRs using race‐specific reference groups converged across maternal ages, indicating a similar independent effect of maternal age on PTB by race/ethnicity. A differential effect of maternal age does not appear to explain disparities in preterm birth by race/ethnicity.

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Section: Methodsmentioning

confidence: 99%

Risks of preterm birth among non‐Hispanic black and non‐Hispanic white women: Effect modification by maternal age

Keiser

Salinas

DeWan

et al. 2019

Paediatric Perinatal Epid

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“…We used a previously described algorithm that has undergone validation by comparison of birth certificate categorization to medical chart data. 12,13 Limitations of our findings should be considered. First, this study is a retrospective one, based on data reported in natality records, and is subject to errors inherent to vital statistics such as errors in self-reporting and misclassification.…”

Section: Strengths and Limitationsmentioning

confidence: 84%

“…PTB was defined as delivery < 37 weeks of gestation. PTB subtype was classified as spontaneous (S-PTB) or indicated (I-PTB) using available birth certificate data according to a previously documented and validated algorithm by Klebanoff et al 12,13 Briefly, S-PTB was defined as PTB after spontaneous labor or preterm rupture of membranes. I-PTB was defined as a preterm delivery for a maternal or fetal indication that required provider initiation of delivery.…”

Section: Methodsmentioning

confidence: 99%

Driving Factors of Preterm Birth Risk in Adolescents

Pérez

Chang

Temming

et al. 2020

AJP Rep

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Objective We examined rates of spontaneous and indicated preterm births (S-PTB and I-PTB, respectively) and clinical risk factors for PTB in adolescents. Study Design This is a population-based, retrospective cohort using 2012 U.S. natality data of nulliparous women who delivered a nonanomalous singleton birth between 20 and 42 weeks' gestation. Maternal age included <16, 16 to 19.9, and ≥20 years. Rates of total, S-PTB, and I-PTB were compared across age groups. Multinomial logistic regression tested clinical risk factors for S-PTB. Results In 1,342,776 pregnancies, adolescents were at higher risk for PTB than adults. The rate of total PTB was highest in young adolescents at 10.6%, decreased to 8.3% in older adolescents, and 7.8% in adults. The proportion of S-PTB was highest in the youngest adolescents and decreased toward adulthood; the proportion of I-PTB remained stable across age groups. Risk factors for S-PTB in adolescents included Asian race, underweight body mass index (BMI), and poor gestational weight gain (GWG). In all age groups, carrying a male fetus showed a significant increased S-PTB, and Women, Infants, and Children's (WIC) participation was associated with a significantly decreased risk. Conclusion The higher risk for PTB in adolescents is driven by an increased risk for S-PTB. Low BMI and poor GWG may be potentially modifiable risk factors. Condensation Adolescents have a higher risk for spontaneous PTB than adult women, and risk factors for spontaneous PTB may differ in adolescents.

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“…Birth certificate‐based algorithms have been developed for research on other outcomes (e.g., spontaneous vs. provider‐initiated preterm birth) (Klebanoff et al. ) and claims data‐based algorithms exist for elective cesarean (Gregory et al. ), and here, we applied a similar approach to categorize term cesarean deliveries.…”

Section: Methodsmentioning

confidence: 99%

“…We developed an algorithm to define four categories of cesarean delivery based on the presence of baseline indications for cesarean, the presence of a trial of labor, and the presence of other markers of labor as recorded on the birth certificate ( Figure 1). Birth certificate-based algorithms have been developed for research on other outcomes (e.g., spontaneous vs. provider-initiated preterm birth) (Klebanoff et al 2016) and claims data-based algorithms exist for elective cesarean (Gregory et al 2002), and here, we applied a similar approach to categorize term cesarean deliveries.…”

Section: Categorizing Cesarean Deliverymentioning

confidence: 99%

Shifting Patterns in Cesarean Delivery Scheduling and Timing in Oregon before and after a Statewide Hard Stop Policy

Muoto

Darney

Lau

et al. 2017

Health Services Research

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Development and Validation of an Algorithm to Determine Spontaneous versus Provider‐Initiated Preterm Birth in US Vital Records

Abstract: The algorithm distinguished spontaneous from indicated preterm birth, using birth certificates, with good accuracy.

Cited by 30 publications

References 26 publications

Risks of preterm birth among non‐Hispanic black and non‐Hispanic white women: Effect modification by maternal age

Risks of preterm birth among non‐Hispanic black and non‐Hispanic white women: Effect modification by maternal age

Driving Factors of Preterm Birth Risk in Adolescents

Shifting Patterns in Cesarean Delivery Scheduling and Timing in Oregon before and after a Statewide Hard Stop Policy

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