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A comparison of risk assessment models for term and preterm low birthweight
R Michielutte1, J M Ernest, M L Moore
1Department of Family and Community Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157-1084.
Insights
This study reveals distinct risk factors for term and preterm low birthweight infants. However, a combined risk assessment model is clinically as effective as separate models for both types of low birthweight.
Area of Science:
- Epidemiology
- Perinatal Health
- Maternal-Child Health
Background:
- Epidemiological research on low birthweight often aggregates term and preterm births.
- Preterm low birthweight has been prioritized due to higher perinatal mortality and morbidity risks.
Purpose of the Study:
- To identify and compare risk factors for term and preterm low birthweights.
- To evaluate the utility of separate multivariate risk assessment systems for clinical application.
Main Methods:
- Analysis of data from 25,408 singleton births in North Carolina.
- Comparison of risk factors for term and preterm low birthweights using multivariate models.
Main Results:
- Overlapping risk factors for both include race, nulliparity, smoking, low pre-pregnancy weight, and prior preterm or low birthweight birth.
- Maternal age shows opposing effects: younger age decreases term low birthweight risk but increases preterm low birthweight risk.
Conclusions:
- Distinct multivariate models are necessary for understanding the epidemiology of preterm and term low birthweights.
- A general risk assessment model for all low birthweight infants offers comparable clinical effectiveness to separate models.
Background:
Most epidemiological research dealing with the assessment of risk for low birthweight has focused on all low birthweight births. Studies that have attempted to distinguish between term and preterm low birthweights have tended to examine preterm low birthweight, since the risk of perinatal mortality and morbidity is greatest for this group of infants.
Method:
This study uses data from 25,408 singleton births in a 20-county region in North Carolina to identify and compare risk factors for term and preterm low birthweights, and also examines the usefulness of separate multivariate risk assessment systems for term and preterm low birthweights that could be used in the clinical setting.
Results:
Risk factors that overlap as significant predictors of both types of low birthweight include race, no previous live births, smoking, weight under 100 lb, and previous preterm or low birthweight birth. Age also is a significant predictor of both types of low birthweight, but in opposite directions. Younger age is associated with reduced risk of term low birthweight and increased risk of pattern low birthweight.
Conclusion:
Comparison of all risk factors indicates that different multivariate models are needed to understand the epidemiology of preterm and term low birthweights. In terms of clinical value, a general risk assessment model that combines all low birthweight births is as effective as the separate models.