Maternal risk factors for preterm birth in Taiwan, a nationwide population-based cohort study

Wu, S L; Lin, Ching-Heng; Lin, Yi‐Hsuan; Hsu, Ya-Chu; Hsu, Chung-Ting; Lin, Ming-Hong

doi:10.1016/j.pedneo.2023.03.014

Cited by 4 publications

(4 citation statements)

References 36 publications

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“…A Taiwanese cohort study revealed that a maternal age of 25-29 years was associated with a lower risk of preterm birth, followed by 30-34 years. In contrast, the >35-year age group showed increased odds [7,30]. These findings suggest that extremes in maternal age may contribute to the heightened risk of CP among LBW infants, possibly due to maternal health conditions or disparities in prenatal care associated with advanced or adolescent maternal age.…”

Section: Discussionmentioning

confidence: 82%

The Prevalence and Risk Analysis of Cerebral Palsy in Children with Low Birth weight in Taiwan: A Nationwide Population-Based Cohort Study

Fan,

Chang,

Lee

et al. 2024

Preprint

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This study aimed to evaluate the early-childhood comorbidities of cerebral palsy (CP) in children with low birth weight (LBW) and assess the impact of maternal bio-psychosocial factors on the risk of CP in preterm infants across varying birth weights. Data for 15,181 prematurely born infants from 2009 to 2013 and 151,810 matched controls from Taiwan's National Health Insurance Research Database were analyzed. Period prevalence of CP, and comorbidities of LBW were verified, and odds ratios (ORs) were calculated. Results confirmed that increasing prematurity and low birth weight (LBW) rates in Taiwan. LBW was associated with higher CP prevalence. Maternal age extremes (&lt;20 and &gt;40 years) were significant risk factors of CP in LBW infants. LBW infants showed higher risks of respiratory, circulatory, and nervous system and psycho-developmental comorbidities compared to controls. Infants with the lowest birth weights had even higher ORs for these comorbidities. However, gastrointestinal and nutritional comorbidities were less prevalent in premature infants. Maternal factors such as family income, number of hospital admissions, and length of hospital stay were significantly correlated with birth weight and subsequent complications. Each additional gestational week significantly reduced the risk of complications in premature infants. Additionally, maternal bio-psychosocial factors were associated with birth weight and related outcomes in premature infants, emphasizing the importance of addressing these factors in prenatal care and interventions.

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Section: Discussionmentioning

confidence: 82%

The Prevalence and Risk Analysis of Cerebral Palsy in Children with Low Birth weight in Taiwan: A Nationwide Population-Based Cohort Study

Fan,

Chang,

Lee

et al. 2024

Preprint

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“…A Taiwanese cohort study presented similar results, revealing that the maternal age of 25–29 years was associated with the lowest risk of preterm birth, followed by 30–34 years. In contrast, the >35-year age group showed increased odds [ 7 , 29 ]. These findings suggest that extremes in maternal age may contribute to the heightened risk of LBW and adverse outcomes, hinting at maternal age as a risk factor for adverse pregnancy outcomes and neurodevelopmental disorders, such as CP, in offspring [ 30 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…While many studies have focused on CP prevalence in preterm populations in Western countries, research on preterm children in Asia is limited [ 6 ]. In Taiwan, prematurity rates have risen steadily, increasing from 8.85% to 10.73% between 2004 and 2014 [ 7 ]. Wang et al’s study using Taiwan’s National Health Insurance Research Database (NHIRD) found the highest CP prevalence among extremely low birth weight (ELBW) preterm children (147.3 cases per 1000 neonatal survivors), followed by very low birth weight (VLBW) preterm (97.2 cases) and LBW preterm (27.7 cases) children, with the lowest prevalence among term-born children (2.5 cases) [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

The Prevalence and Risk Analysis of Cerebral Palsy and Other Neuro-Psychological Comorbidities in Children with Low Birth Weight in Taiwan: A Nationwide Population-Based Cohort Study

Fan,

Chang,

Lee

et al. 2024

JCM

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Background: This study evaluated early childhood comorbidities of cerebral palsy (CP) in low birth weight (LBW) children and assessed the impact of maternal bio-psychosocial factors on CP risk in preterm infants of varying birth weights (BWs). Methods: Data from 15,181 preterm infants (2009–2013) and 151,810 controls were analyzed using Taiwan’s National Health Insurance Research Database. CP prevalence and LBW-associated comorbidities were examined, and odds ratios (ORs) were calculated. Results: This study confirmed increasing prematurity and LBW rates in Taiwan, with LBW infants showing higher CP prevalence. Significant maternal risk factors included age extremes (<20 and >40 years). LBW infants exhibited higher risks for respiratory, circulatory, nervous system, and psycho-developmental comorbidities compared with controls, with the lowest BW having even higher ORs. Maternal factors such as family income, the number of hospital admissions, and length of hospital stay were remarkably correlated with BW and subsequent complications. Each additional gestational week crucially reduced the risk of complications in premature infants. Conclusions: LBW infants are at a higher risk for CP and various comorbidities, with maternal bio-psychosocial factors playing a critical role. Addressing these factors in prenatal care and interventions is essential to improve outcomes for premature infants.

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“…In Taiwan, the incidence of preterm births has gradually increased from 8.85% in 2004 to 10.73% in 2014, a trend observed on a global scale 6 Notably, the preterm birth rate in Taiwan has surpassed that in most OECD countries 7 However, to the best of our knowledge, the existing literature has only identified certain risk factors associated with mortality and severe IVH in Taiwan 8 – 10 The establishment of a nationwide outcome predictor applicable for the Taiwanese population remains an unmet need.…”

Section: Introductionmentioning

confidence: 99%

Predicting early mortality and severe intraventricular hemorrhage in very-low birth weight preterm infants: a nationwide, multicenter study using machine learning

Yang,

Wang,

et al. 2024

Sci Rep

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Our aim was to develop a machine learning-based predictor for early mortality and severe intraventricular hemorrhage (IVH) in very-low birth weight (VLBW) preterm infants in Taiwan. We collected retrospective data from VLBW infants, dividing them into two cohorts: one for model development and internal validation (Cohort 1, 2016–2021), and another for external validation (Cohort 2, 2022). Primary outcomes included early mortality, severe IVH, and early poor outcomes (a combination of both). Data preprocessing involved 23 variables, with the top four predictors identified as gestational age, birth body weight, 5-min Apgar score, and endotracheal tube ventilation. Six machine learning algorithms were employed. Among 7471 infants analyzed, the selected predictors consistently performed well across all outcomes. Logistic regression and neural network models showed the highest predictive performance (AUC 0.81–0.90 in both internal and external validation) and were well-calibrated, confirmed by calibration plots and the lowest two mean Brier scores (0.0685 and 0.0691). We developed a robust machine learning-based outcome predictor using only four accessible variables, offering valuable prognostic information for parents and aiding healthcare providers in decision-making.

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Maternal risk factors for preterm birth in Taiwan, a nationwide population-based cohort study

Cited by 4 publications

References 36 publications

The Prevalence and Risk Analysis of Cerebral Palsy in Children with Low Birth weight in Taiwan: A Nationwide Population-Based Cohort Study

The Prevalence and Risk Analysis of Cerebral Palsy in Children with Low Birth weight in Taiwan: A Nationwide Population-Based Cohort Study

The Prevalence and Risk Analysis of Cerebral Palsy and Other Neuro-Psychological Comorbidities in Children with Low Birth Weight in Taiwan: A Nationwide Population-Based Cohort Study

Predicting early mortality and severe intraventricular hemorrhage in very-low birth weight preterm infants: a nationwide, multicenter study using machine learning

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