Does the Relationship between Prenatal Care and Birth Weight Vary by Oral Clefts? Evidence Using South American and United States Samples

Abstract

Objective To evaluate if the association between prenatal care use and birth weight (BW) varies for infants with cleft lip and/or cleft palate (CL/P), classified into isolated and non-isolated forms, compared with unaffected infants. Study design The study employed two datasets. The first included a multi-country sample of 2,405 infants with CL/P and 24,046 infants without CL/P born in 1996–2007 in South America. The second was a sample of 2,122 infants with CL/P and 297,415 without CL/P from the United States (U.S.) 2004 Natality dataset. Separate analyses were performed for the South American and U.S. samples. The association between prenatal care and BW was evaluated separately for isolated CL/P, non-isolated CL/P, and unaffected infants using regression models adjusting for several background characteristics. Results Prenatal care was associated with improved BW for all infant groups, with greater BW increases for infants with CL/P particularly non-isolated forms. In the South American sample, BW increased by 108, 69, and 40 grams on average per prenatal visit for infants with non-isolated CL/P, infants with isolated CL/P, and unaffected infants, respectively. In the U.S. sample, BW increased by 51, 21, and 16 grams on average per prenatal visit for these infant groups, respectively. Conclusions Prenatal care was associated with larger BW increases for pregnancies complicated with CL/P, particularly non-isolated forms, compared with unaffected pregnancies. Given that reduced BW is a well-recognized co-morbidity of CL/P, the findings highlight the importance of prenatal care for at-risk pregnancies as a tertiary-prevention intervention to reduce the health burden of CL/P.

Gestational age and birth weight variations in young children with language impairment at an early communication intervention clinic

“…Low birth weight and/or preterm birth has recently been identified as a risk for autism spectrum disorder (ASD) (Kihara & Nakamura, 2015 ). Infants born with syndromic cleft lip and/or palate (CLP) are at risk for lower birth weight of up to 600 g less than unaffected infants (Nyarko, Lopez-Camelo, Castilla, & Wehby, 2013 ). Similarly, infants who are exposed to the human immunodeficiency virus (HIV) are at risk for very LBW, atypical length and head circumference, and neurodevelopmental deficits and feeding difficulties associated with HIV-encephalopathy (Kihara & Nakamura, 2015 ).…”

Determinantes sociales adversos y riesgo para anomalías congénitas seleccionadas

“…Esta última observación adquiere suma importancia debido a que se ha relacionado este defecto con un mayor riesgo en ancestría nativa, 21 orden de gravidez 22 y pocas visitas prenatales. 23 Del mismo modo, el efecto de la edad materna ha sido reportado para la comunicación interventricular. 24 Mediante el ajuste por el índice de propensión, los casos y controles presentaron, en promedio, la misma edad materna, orden de gravidez, número de consultas prenatales y frecuencia de ancestros nativos, por lo que estas variables no interferirían en la interpretación de los resultados.…”

The impact of unemployment cycles on child and maternal health in Argentina

“…The ECLAMC data have been used in numerous studies of infant and maternal health in South America (e.g. Wehby et al, 2009a, 2009b, 2009c; 2010; Nyarko et al 2013a, 2013b; Wehby et al 2014; Woodhouse et al 2014; Wehby et al, 2015). …”

“…This period covers the 1995 recession and the major 1999–2002 economic crisis. We exclude infants with birth defects from this sample because the infant health outcomes we investigate such as birth weight, gestational age, or hospitalization status are influenced by birth defects (Nyarko et al, 2013b; Wehby et al, 2009b, 2014). The total sample with data on the study variables includes around 15,000 births born in 50 hospitals in 29 cities in 13 provinces.…”