Effect of gestational disorders on preterm birth, low birthweight, and NICU admission
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MATERNAL-FETAL MEDICINE
Effect of gestational disorders on preterm birth, low birthweight, and NICU admission Chaitali Ghosh1,2 · Martha Wojtowycz2 Received: 21 January 2020 / Accepted: 24 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective Many modifiable maternal behaviors and experiences before and during pregnancy are associated with adverse health outcomes. The relationship between a number of maternal and gestational disorders and perinatal outcomes (preterm birth, low birth weight and neonatal intensive care unit (NICU)) admission in the Central New York population is determined using the Statewide Perinatal Data System, in a retrospective population-based cohort study. Methods Singleton births excluding newborns with congenital anomalies among 165,739 women between 2004 and 2012 are included in this study. Multivariable logistic regression analysis is used to estimate odds ratios (OR) and 95% confidence intervals (CI) adjusted for maternal age, race, education, employment, parity, body mass index, smoking, drug use, depression, abortions, gender of child, prenatal care, and hospital level. Results Previous preterm birth and vaginal bleeding are independent high-risk factors for all three perinatal outcomes, prepregnancy diabetes (OR 4.95, 95% CI 4.34, 5.64) for preterm birth and (OR 7.45, 95% CI 6.58, 8.44) for NICU admission; and gestational hypertension (OR 4.35, 95% CI 4.03, 4.70) for low birth weight. Among infections, bacterial vaginosis is retained in the multivariable model as a risk factor for preterm and low birth weight while hepatitis C is a risk factor for NICU admission. Conclusions Our findings suggest the continued importance of addressing the need to provide preconception and inter conception care for women since many modifiable risk factors are correlated and need to be addressed well before the woman becomes pregnant. Keywords Preterm · Low birth weight · NICU · Maternal · Perinatal · Gestational
Introduction The perinatal period may be defined as the time period just before, during, and after birth, and pregnancy outcomes can be considered independent outcomes, exposures, or intermediates on causal pathways between exposures and child outcomes [1]. Adverse perinatal outcomes broadly include preterm birth, infants with low birth weight and those requiring NICU admission. Preterm birth is the * Chaitali Ghosh [email protected] 1
Department of Mathematics, SUNY College At Buffalo, A257 Buckham Hall, 1300 Elmwood Avenue, Buffalo, NY 14222, USA
Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, 766 Irving Avenue, Syracuse, NY 13210, USA
2
birth of an infant before 37 weeks of gestation. In 2004, 12.5% of births in the United States were preterm and in 2013, the preterm birth rate declined to 11.4% [2, 3]. The rate of preterm births in the US is believed to be higher than in most other developed countries, and the variation in risk among certain subgroups in the population is not completely unde
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