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Etiology of low-birthweight birth: a population-based study
M L Moore1, R Michielutte, P J Meis
1Department of Obstetrics and Gynecology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27157.
Insights
Understanding the causes of preterm and low-birthweight (LBW) births is key to reducing infant mortality. Different maternal factors are linked to distinct LBW and preterm birth etiologies, requiring tailored prevention strategies.
Area of Science:
- Obstetrics and Gynecology
- Neonatology
- Public Health
Background:
- Preterm and low-birthweight (LBW) births are primary drivers of infant mortality in the U.S.
- Identifying diverse etiologies of these births is crucial for developing targeted preventive measures.
Purpose of the Study:
- To classify LBW births into distinct etiologic groups.
- To analyze the associations between maternal demographics and these etiologies.
Main Methods:
- Utilized vital statistics and maternal hospital records for 4,754 mothers in 20 North Carolina counties.
- Classified births into four groups: term-LBW, medically indicated preterm, preterm premature rupture of membranes, and idiopathic preterm.
- Merged birth certificate and hospital data for comprehensive analysis.
Main Results:
- Demographic factors like race, age, education, and marital status showed varied associations with etiologies.
- Black and younger women had higher rates across all etiologies, but white women accounted for the highest absolute number of LBW births.
- Idiopathic preterm birth was most common in Black women and decreased with age, while medically indicated preterm births increased with maternal age.
Conclusions:
- Classifying LBW births by etiology offers valuable insights for clinicians and researchers.
- Incorporating etiologic identification will enhance studies on LBW and preterm birth.
- Developing multiple, etiology-specific preventive strategies is recommended.
Background:
Preterm and low-birthweight births remain the major correlates of infant mortality in the United States. The recognition that these births result from varying proximal etiologies is essential to the development of preventive strategies specific to each etiologic group.
Methods:
Using vital statistics data tapes provided by the North Carolina Center for Health and Environmental Statistics, mothers in 20 counties who delivered infants with birthweights between 1 pound and 5 pounds, 8 ounces were identified. Maternal hospital records of 4,754 women were reviewed for data about prenatal and intrapartal events. Two perinatologists classified births into four proximal etiology groups: term-lowbirthweight, medically indicated preterm birth, preterm premature rupture of membranes, and idiopathic preterm birth. Information from birth certificate and hospital records was merged to provide an expanded data set.
Results:
Race, age, education, and marital status are associated with different patterns of proximal etiology. Rates were higher for all etiologies in black women and in young women; however, the absolute number of LBW births was highest among white women. Idiopathic preterm birth was highest in black women and decreased as age increased; medical indications for preterm birth increased with increasing age.
Conclusions:
Classification of LBW births by etiologic group provides insights of value to both clinicians and researchers. Studies in which LBW and/or preterm birth are the outcome variables will be enhanced by identifying etiology. Multiple preventive strategies should address varying etiologic groups.