The risk of low birthweight.

Abstract

Descriptive analyses of birthweight for single live births in the United States during 1974, using birth certificate information, show that several factors are associated with a high incidence of low birthweight babies. Multivariate analyses were performed to determine correlates of low birthweight. When other factors are held constant, race not white, previous reproductive loss, short interpregnancy interval, outof-wedlock birth, no prenatal care, and maternal age Recent studies of pregnancy outcome have shown a progressive decline of perinatal and infant mortality in all risk categories, including mortality for small preterm infants.' The decline has come at a time of change in many aspects of maternal and infant care: associated factors include improved perinatal services available to both mother and baby, improved care or prevention of specific diseases, and an increased availability of means for spacing or preventing pregnancies.In our study of birth certificate information to evaluate specific factors which increase the risk of a poor pregnancy outcome, we have followed the suggestion of Lewis, et al.,2 and use birthweight distribution as an indicator of pregnancy outcome. Although infant mortality rates remain the primary indicator, low birthweight is also an indicator of considerable interest. Low birthweight is associated with increased perinatal and infant mortality and morbidity, including adverse sequelae such as mental retardation and learning disabilities.Many previous studies have shown that birthweight, in- The study from which the present report has been drawn'4 comprised an examination of United States birth registration data for single live births in 1974. For each race it related the proportion of births which were low birthweight (less than 2501 grams) to risk factors ascertainable from birth certificates. We summarize here the principal findings of that study and report the results of multivariate analyses which examine the risk of having a low birthweight baby by race, maternal age, wedlock status, prenatal care, and maternal education for primigravida, and by these factors and birth order, reproductive history, and interpregnancy interval for multigravida.

Self-Reported Reproductive Outcomes Among Male and Female 1991 Gulf War era US Military Veterans

“…In multivariable modeling, age was not significantly associated with adverse reproductive outcomes for men or women; however, black, non-Hispanic women were significantly associated with increased odds for an adverse reproductive outcome in comparison with white, non-Hispanic women. This finding has been thoroughly documented in the US civilian population [51][52][53], and because we assume equal access to prenatal care among all active duty families, the observed modest association (adjusted OR, 1.45; 95% CI, 1.13-1.86), may reflect other pregnancy-related differences between black non-Hispanic women and white non-Hispanic women of approximately equal reproductive age, such as differences in obesity, hypertension, and diabetes [53][54][55][56][57]. A previous study utilized adult, married military members living in Hawaii and birth records to examine race/ethnicity differences in pregnancy outcomes [58].…”

Atenção médica à gestação e ao parto de mães adolescentes

“…Vários autores (Stickle & Ma, 1977;Quick, 1981) também encontraram associação entre peso ao nascer e assistência pré-natal, utilizando diferentes critérios para a definição desta assistência. Eisner et al (1979), nos EUA, verificaram que a ausência de assistência pré-natal foi o fator de risco mais intensamente associado ao baixo peso de nascimento. Gortmaker (1979) observou, utilizando dados de todos os nascimentos e dos óbitos infantis da cidade de Nova York, em 1968, uma associação significante entre ausência de cuidado pré-natal e mortalidade infantil, principalmente por haver forte relação entre pré-natal inadequado e baixo peso ao nascer.…”

“…Muitos autores têm estudado o impacto do peso ao nascer sobre os níveis de morbidade e mortalidade na infância, pois esta variável tem sido reconhecida como o parâmetro mais importante relacionado com a doença e a morte no primeiro ano de vida (Butler & Alberman, 1969;Puffer & Serrano, 1975;Teruel et al, 1975;Barros-Filho, 1976;Eisner et al, 1979;Monteiro, 1979;Benício, 1983;Barros et al, 1984;Barbieri, 1985;Puffer & Serrano, 1987;Almeida, 1988). Apesar das limitações apontadas a essa medida, como, por exemplo, a de que um dado peso de nascimento pode refletir diferentes níveis de maturidade, a facilidade de sua obtenção em níveis populacionais e a nitidez com que reflete interferências que tenham ocorrido antes ou durante a gestação justificam a confiabilidade que lhe é conferida no estudo da vitalidade infantil ao nascer e das possibilidades de sobrevivência saudável da criança no futuro (Barros-Filho, 1976).…”

“…A idade da mãe na época do parto é um dos fatores imputados como sendo de grande importância na gênese do RN de baixo peso, ou seja, com peso de nascimento menor que 2500 gramas (WHO, 1977), sendo que os extremos da vida reprodutiva feminina -menos de 20 e mais de 35 anos de idade -apresentam as maiores taxas de baixo peso ao nascer e maiores mortalidades neonatal e infantil (Eisner et al, 1979;Siqueira et al, 198 1b;Van Den Berg, 1981;The Lancet, 1989; American Academy of Pediatrics, 1989).…”

On getting the most out of multivariate data analyses.

“…[1][2][3] The data sources dictated the variables that could be considered in the three analyses presented. The authors also had different motivations for undertaking the work: being biologically oriented,' having a medical care policy orientation,3 and being some of each.2 Thus the results presented are not directly comparable.…”