Mortality among infants with birth defects: Joint effects of size at birth, gestational age, and maternal race/ethnicity

2010 ◽  
Vol 88 (9) ◽  
pp. 728-736 ◽  
Author(s):  
Wendy N. Nembhard ◽  
Jason L. Salemi ◽  
Mary K. Ethen ◽  
David E. Fixler ◽  
Mark A. Canfield
Keyword(s):  
Birth Defects ◽  
Gestational Age ◽  
Joint Effects ◽  
Race Ethnicity ◽  
Size At Birth ◽  
Maternal Race

Spina bifida subtypes and sub-phenotypes by maternal race/ethnicity in the National Birth Defects Prevention Study

2011 ◽  
Vol 158A (1) ◽  
pp. 109-115 ◽  
Author(s):  
A.J. Agopian ◽  
Mark A. Canfield ◽  
Richard S. Olney ◽  
Philip J. Lupo ◽  
Tunu Ramadhani ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Birth Defects ◽  
Prevention Study ◽  
Race Ethnicity ◽  
Maternal Race

scholarly journals Temporal Trends in Chorioamnionitis by Maternal Race/Ethnicity and Gestational Age (1995–2010)

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Michael J. Fassett ◽  
Deborah A. Wing ◽  
Darios Getahun
Keyword(s):  
Gestational Age ◽  
Temporal Trends ◽  
Relative Increase ◽  
Pacific Islanders ◽  
Kaiser Permanente ◽  
Asian Pacific Islanders ◽  
Diagnosis Rate ◽  
Race Ethnicity ◽  
Asian Pacific ◽  
Maternal Race

Objective. To characterize trends in chorioamnionitis (CAM) by maternal race/ethnicity and gestational age.Study Design. We examined trends in CAM from 1995–2010 among singleton births in all Kaiser Permanente Southern California hospitals (). Data were extracted from Perinatal Service System and clinical utilization records. Gestational age- and race/ethnicity-specific biannual diagnosis rates were estimated using the Poisson regression after adjusting for potential confounding factors.Results. Overall diagnosis rates of CAM increased from 2.7% in 1995-1996 to 6.0% in 2009-2010 with a relative increase of 126% (95% confidence intervals [CI] 113%–149%). From 1995-1996 to 2009-2010, CAM increased among the Whites (1.8% to 4.3%, -value for trend <.001), Blacks (2.2% to 3.7%, -value for trend <.001), Hispanics (2.4% to 5.8%, -value for trend <.001), and Asian/Pacific Islanders (3.6% to 9.0%, -value for trend <.001). The adjusted relative percentage change in CAM from 1995-1996 to 2009-2010 was for Whites [preterm 21% (9%–78%), term 138% (108%–173%)], for Blacks [preterm 24% (−9%–81%), term 62% (30%–101%)], for Hispanics [preterm 31% (3%–66%), term 135% (114%–159%)], and for Asian/Pacific Islanders [preterm 44% (9%–127%), term 145% (109%–188%)].Conclusion. The findings suggest that CAM diagnosis rate has increased for all race/ethnic groups. This increase is primarily due to increased diagnosis at term gestation.

scholarly journals Racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245064
Author(s):  
Anne L. Dunlop ◽  
Alicynne Glazier Essalmi ◽  
Lyndsay Alvalos ◽  
Carrie Breton ◽  
Carlos A. Camargo ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Maternal Education ◽  
Bachelor's Degree ◽  
Race Ethnicity ◽  
Gestational Age At Birth ◽  
Age At Birth ◽  
Neighborhood Level ◽  
Hispanic White ◽  
Maternal Race

Preterm birth occurs at excessively high and disparate rates in the United States. In 2016, the National Institutes of Health (NIH) launched the Environmental influences on Child Health Outcomes (ECHO) program to investigate the influence of early life exposures on child health. Extant data from the ECHO cohorts provides the opportunity to examine racial and geographic variation in effects of individual- and neighborhood-level markers of socioeconomic status (SES) on gestational age at birth. The objective of this study was to examine the association between individual-level (maternal education) and neighborhood-level markers of SES and gestational age at birth, stratifying by maternal race/ethnicity, and whether any such associations are modified by US geographic region. Twenty-six ECHO cohorts representing 25,526 mother-infant pairs contributed to this disseminated meta-analysis that investigated the effect of maternal prenatal level of education (high school diploma, GED, or less; some college, associate’s degree, vocational or technical training [reference category]; bachelor’s degree, graduate school, or professional degree) and neighborhood-level markers of SES (census tract [CT] urbanicity, percentage of black population in CT, percentage of population below the federal poverty level in CT) on gestational age at birth (categorized as preterm, early term, full term [the reference category], late, and post term) according to maternal race/ethnicity and US region. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CIs). Cohort-specific results were meta-analyzed using a random effects model. For women overall, a bachelor’s degree or above, compared with some college, was associated with a significantly decreased odds of preterm birth (aOR 0.72; 95% CI: 0.61–0.86), whereas a high school education or less was associated with an increased odds of early term birth (aOR 1.10, 95% CI: 1.00–1.21). When stratifying by maternal race/ethnicity, there were no significant associations between maternal education and gestational age at birth among women of racial/ethnic groups other than non-Hispanic white. Among non-Hispanic white women, a bachelor’s degree or above was likewise associated with a significantly decreased odds of preterm birth (aOR 0.74 (95% CI: 0.58, 0.94) as well as a decreased odds of early term birth (aOR 0.84 (95% CI: 0.74, 0.95). The association between maternal education and gestational age at birth varied according to US region, with higher levels of maternal education associated with a significantly decreased odds of preterm birth in the Midwest and South but not in the Northeast and West. Non-Hispanic white women residing in rural compared to urban CTs had an increased odds of preterm birth; the ability to detect associations between neighborhood-level measures of SES and gestational age for other race/ethnic groups was limited due to small sample sizes within select strata. Interventions that promote higher educational attainment among women of reproductive age could contribute to a reduction in preterm birth, particularly in the US South and Midwest. Further individual-level analyses engaging a diverse set of cohorts are needed to disentangle the complex interrelationships among maternal education, neighborhood-level factors, exposures across the life course, and gestational age at birth outcomes by maternal race/ethnicity and US geography.

scholarly journals Exposure to Gestational Diabetes Is a Stronger Predictor of Dysmetabolic Traits in Children Than Size at Birth

2018 ◽  
Vol 104 (5) ◽  
pp. 1766-1776 ◽  
Author(s):  
Freja Bach Kampmann ◽  
Anne Cathrine Baun Thuesen ◽  
Line Hjort ◽  
Sjurdur Frodi Olsen ◽  
Sara Monteiro Pires ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Birth Cohort ◽  
Gestational Age ◽  
Metabolic Profile ◽  
Large For Gestational Age ◽  
Independent Effect ◽  
Birth Cohort Study ◽  
Childhood And Adolescence ◽  
Size At Birth ◽  
Cardiometabolic Traits

Abstract Context and Objective Being born small or large for gestational age and intrauterine exposure to gestational diabetes (GDM) increase the risk of type 2 diabetes in the offspring. However, the potential combined deleterious effects of size at birth and GDM exposure remains unknown. We examined the independent effect of size at birth and the influence of GDM exposure in utero on cardiometabolic traits, body composition, and puberty status in children. Design, Participants, and Methods The present study was a longitudinal birth cohort study. We used clinical data from 490 offspring of mothers with GDM and 527 control offspring aged 9 to 16 years, born singleton at term from the Danish National Birth Cohort with available birthweight data. Results We found no evidence of a U-shaped association between size at birth (expressed as birthweight, sex, and gestational age adjusted z-score) and cardiometabolic traits. Body size in childhood and adolescence reflected the size at birth but was not reflected in any metabolic outcome. No synergistic adverse effect of being born small or large for gestational age and exposure to GDM was shown. However, GDM was associated with an adverse metabolic profile and earlier onset of female puberty in childhood and adolescence independently of size at birth. Conclusion In childhood and adolescence, we found GDM was a stronger predictor of dysmetabolic traits than size at birth. The combination of being born small or large and exposed to GDM does not exacerbate the metabolic profile in the offspring.

scholarly journals A birth population-based survey of preterm morbidity and mortality by gestational age

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaojing Guo ◽  
Xiaoqiong Li ◽  
Tingting Qi ◽  
Zhaojun Pan ◽  
Xiaoqin Zhu ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Preterm Infants ◽  
Birth Defects ◽  
Gestational Age ◽  
Death Rate ◽  
Preterm Births ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Hospital Death

Abstract Background Despite 15–17 millions of annual births in China, there is a paucity of information on prevalence and outcome of preterm birth. We characterized the outcome of preterm births and hospitalized preterm infants by gestational age (GA) in Huai’an in 2015, an emerging prefectural region of China. Methods Of 59,245 regional total births, clinical data on 2651 preterm births and 1941 hospitalized preterm neonates were extracted from Huai’an Women and Children’s Hospital (HWCH) and non-HWCH hospitals in 2018–2020. Preterm prevalence, morbidity and mortality rates were characterized and compared by hospital categories and GA spectra. Death risks of preterm births and hospitalized preterm infants in the whole region were analyzed with multivariable Poisson regression. Results The prevalence of extreme, very, moderate, late and total preterm of the regional total births were 0.14, 0.53, 0.72, 3.08 and 4.47%, with GA-specific neonatal mortality rates being 44.4, 15.8, 3.7, 1.5 and 4.3%, respectively. There were 1025 (52.8% of whole region) preterm admissions in HWCH, with significantly lower in-hospital death rate of inborn (33 of 802, 4.1%) than out-born (23 of 223, 10.3%) infants. Compared to non-HWCH, three-fold more neonates in HWCH were under critical care with higher death rate, including most extremely preterm infants. Significantly all-death risks were found for the total preterm births in birth weight <  1000 g, GA < 32 weeks, amniotic fluid contamination, Apgar-5 min < 7, and birth defects. For the hospitalized preterm infants, significantly in-hospital death risks were found in out-born of HWCH, GA < 32 weeks, birth weight <  1000 g, Apgar-5 min < 7, birth defects, respiratory distress syndrome, necrotizing enterocolitis and ventilation, whereas born in HWCH, antenatal glucocorticoids, cesarean delivery and surfactant use decreased the death risks. Conclusions The integrated data revealed the prevalence, GA-specific morbidity and mortality rate of total preterm births and their hospitalization, demonstrating the efficiency of leading referral center and whole regional perinatal-neonatal network in China. The concept and protocol should be validated in further studies for prevention of preterm birth.

scholarly journals Impact of size at birth and postnatal growth on metabolic and neurocognitive outcomes in prematurely born school-age children

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoo Jinie Kim ◽  
Seung Han Shin ◽  
Eun Sun Lee ◽  
Young Hwa Jung ◽  
Young Ah Lee ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Growth Velocity ◽  
Postnatal Growth ◽  
School Age ◽  
Z Score ◽  
Neurodevelopmental Outcomes ◽  
Neurocognitive Outcomes ◽  
Size At Birth

AbstractPrematurity, size at birth, and postnatal growth are important factors that determine cardiometabolic and neurodevelopmental outcomes later in life. In the present study, we aimed to investigate the associations between the size at birth and growth velocity after birth with cardiometabolic and neurodevelopmental outcomes in preterm infants. Fifty-six preterm infants born at < 32 weeks of gestation or having a birth weight of < 1500 g were enrolled and categorized into small for gestational age (SGA) and appropriate for gestational age (AGA) groups. Anthropometric and cardiometabolic parameters were assessed at school-age, and the Korean Wechsler Intelligence Scale for Children, fourth edition (K-WISC-IV) was used for assessing the intellectual abilities. The growth velocity was calculated by changes in the weight z-score at each time period. Multivariate analysis was conducted to investigate the associations of growth velocity at different periods with cardiometabolic and neurodevelopmental outcomes. Forty-two (75%) were classified as AGA and 25% as SGA. At school-age, despite the SGA children showing significantly lower body weight, lean mass index, and body mass index, there were no differences in the cardiometabolic parameters between SGA and AGA groups. After adjusting for gestational age, birth weight z-score, weight z-score change from birth to discharge and sex, change in weight z-score beyond 12 months were associated with a higher systolic blood pressure, waist circumference, and insulin resistance. Full-scale intelligent quotient (β = 0.314, p = 0.036) and perceptional reasoning index (β = 0.456, p = 0.003) of K-WISC-IV were positively correlated with postnatal weight gain in the neonatal intensive care unit. Although cardiometabolic outcomes were comparable in preterm SGA and AGA infants, the growth velocity at different time periods resulted in different cardiometabolic and neurocognitive outcomes. Thus, ensuring an optimal growth velocity at early neonatal period could promote good neurocognitive outcomes, while adequate growth after 1 year could prevent adverse cardiometabolic outcomes in preterm infants.

Maternal occupation as a nail technician or hairdresser during pregnancy and birth defects, National Birth Defects Prevention Study, 1997–2011

2021 ◽  
pp. oemed-2021-107561
Author(s):  
Miriam R Siegel ◽  
Carissa M Rocheleau ◽  
Kendra Broadwater ◽  
Albeliz Santiago-Colón ◽  
Candice Y Johnson ◽  
...  
Keyword(s):  
Birth Defects ◽  
Cleft Lip ◽  
Population Based ◽  
Small Samples ◽  
Prevention Study ◽  
Control Data ◽  
Reproductive Effects ◽  
Race Ethnicity ◽  
Maternal Occupation ◽  
Pregnancy And Birth

ObjectiveNail technicians and hairdressers may be exposed to chemicals with potential reproductive effects. While studies have examined birth defects in children of hairdressers, those in children of nail technicians have not been evaluated. We investigated associations between selected birth defects and maternal occupation as a nail technician or hairdresser versus a non-cosmetology occupation during pregnancy.MethodsWe analysed population-based case–control data from the multisite National Birth Defects Prevention Study, 1997–2011. Cases were fetuses or infants with major structural birth defects; controls were live-born infants without major birth defects. Expert raters classified self-reported maternal jobs as nail technician, combination nail technician-hairdresser, hairdresser, other cosmetology work or non-cosmetology work. We used logistic regression to calculate adjusted ORs and 95% CIs for associations between occupation during pregnancy and birth defects, controlling for age, smoking, education and race/ethnicity.ResultsSixty-one mothers worked as nail technicians, 196 as hairdressers, 39 as combination nail technician-hairdressers and 42 810 as non-cosmetologists. The strongest associations among nail technicians included seven congenital heart defect (CHD) groups (ORs ranging from 2.7 to 3.5) and neural tube defects (OR=2.6, CI=0.8 to 8.4). Birth defects most strongly associated with hairdressing included anotia/microtia (OR=2.1, CI=0.6 to 6.9) and cleft lip with cleft palate (OR=2.0, CI=1.1 to 3.7). All oral cleft groups were associated with combination nail technician-hairdresser work (ORs ranging from 4.2 to 5.3).ConclusionsSmall samples resulted in wide CIs. Still, results suggest associations between maternal nail technician work during pregnancy and CHDs and between hairdressing work and oral clefts.

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